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Nationwide trends of clinical characteristics and economic burden of emergency department visits due to acute ischemic stroke
Authors Stuntz M, Busko K, Irshad S, Paige T, Razhkova V, Coan T
Received 18 July 2017
Accepted for publication 29 August 2017
Published 19 September 2017 Volume 2017:9 Pages 89—96
DOI https://doi.org/10.2147/OAEM.S146654
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Hans-Christoph Pape
Mark Stuntz, Katsiaryna Busko, Shumaila Irshad, Taylor Paige, Veranika Razhkova, Tim Coan
Deerfield Institute, New York, NY, USA
Abstract: We aimed to provide estimates of the volume and associated charges of acute ischemic stroke (AIS) visits in the US, as well as to assess predictors of patient disposition following an emergency department (ED) visit for AIS. Our study was conducted using the 2010–2013 data from the Nationwide Emergency Department Sample. We identified adult visits with AIS as the primary diagnosis. A generalized linear model was used to calculate mean charges per visit after adjusting for covariates. Multinomial logistic regression was used to assess predictors of patient disposition following an ED visit for AIS. The national incidence did not appreciably change over time, increasing from 26.4 to 27.0 visits per 10,000 adults. Adjusted mean charges per event were highest in the West, increasing from $3,761 in 2010 to $4,575 in 2013. Multinomial logistic regression showed that older age was associated with increased likelihood of both hospital admission and mortality in the ED, while male sex was associated with lower odds of mortality in the ED. Despite improvements in primary and secondary prevention of cardiovascular disease, AIS remains a significant burden on the health care system with a high volume of ED visits and increasing charges for care.
Keywords: epidemiology, ischemic, stroke, patient disposition, hospital charges
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