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Updated: Nov 26, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Cost-Effectiveness of Using LDL-Direct Versus Lipid-Panel as Part of the Inpatient Stroke Workup
Richard Lane1, Kunal Agrawal1, Royya Modir2
1UC San Diego Hospital, 200 West Arbor Dr., San Diego, CA 92103, United States.
Insights
Using an LDL-direct test instead of a lipid panel for stroke patients can save healthcare systems significant money. This approach offers a more cost-effective method for managing dyslipidemia and guiding statin therapy.
Area of Science:
- Cardiovascular Medicine
- Health Economics
- Clinical Laboratory Science
Background:
- Stroke and transient ischemic attack (TIA) workups often include lipid testing.
- Accurate low-density lipoprotein cholesterol (LDL-C) measurement is crucial for guiding dyslipidemia management, including statin initiation.
- Current practices may involve using a standard lipid panel, which includes LDL-C calculation.
Purpose of the Study:
- To compare the cost-effectiveness of using an LDL-direct laboratory test versus a traditional lipid panel for inpatient stroke and TIA evaluations.
- To assess the financial impact on both patients and the hospital system.
- To evaluate the influence of accurate LDL-C on statin therapy initiation.
Main Methods:
- Retrospective analysis of 1245 patients admitted for ischemic stroke or TIA between July 2016 and June 2019.
- Cost analysis based on UCSD hospital billing data from June 2020.
- Examination of statin initiation in patients not previously on therapy.
Main Results:
- The study included 1245 patients (87% ischemic stroke, 13% TIA).
- Utilizing LDL-direct testing instead of a lipid panel could result in $77,545 in savings over three years, a 33% cost reduction.
- 43% of patients were initiated on statin therapy during their admission.
Conclusions:
- The LDL-direct test is a more cost-effective option than the lipid panel for assessing LDL-C in stroke and TIA patients.
- This approach offers potential financial benefits to both patients and the healthcare system.
- Optimizing LDL-C measurement can improve dyslipidemia management and therapeutic decisions.
Objective:
To investigate whether utilizing a LDL-direct laboratory test rather than a lipid panel to determine LDL-C as part of the inpatient stroke and TIA workup is more cost-effective to the patient and hospital system. A retrospective analysis was conducted on all patients admitted to UCSD La Jolla and Hillcrest Hospital and discharged with a final diagnosis of ischemic stroke or transient ischemic attack between 7/2016 and 6/2019. A cost-analysis was extrapolated based on the current cost of each test as provided by the UCSD hospital billing department as of June 2020. Patients started on a statin, who were not on one prior to admission, were also analyzed to highlight the importance of an accurate LDL-C on management of dyslipidemia.
Results:
A total of 1245 patients were included in the study with 87% representing Ischemic strokes and 13% transient ischemic attacks. Over the three-year period, a total savings of $77,545 would be achieved if LDL-direct were used in place of a lipid-panel, representing an overall cost savings of 33%. Over the same time-frame, 536 (43%) patients were started on a statin that were not previously on one.
Conclusions:
Ordering a LDL-direct test should be considered over a lipid panel to evaluate LDL-C as it may prove to be the most cost effective approach to both the patient and Healthcare system.
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