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Updated: May 9, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Predictors of In-Hospital Mortality Among Patients With Acute Stroke: Insights From the Healthcare Cost and
Azhar Ushmani1, Sandipkumar Patel2, Priji Prasad Jalaja3
1Department of Information Security, Amazon Web Service (AWS), Dallas, USA.
Insights
Acute stroke mortality is higher in older patients with more comorbidities. Non-survivors incurred higher costs and longer hospital stays, highlighting the need for targeted interventions.
Area of Science:
- Neurology
- Public Health
- Healthcare Management
Background:
- Acute stroke (cerebral infarction) is a major global cause of death and disability.
- Patient outcomes are significantly impacted by demographics, existing health conditions, and hospital factors.
- Understanding differences between stroke survivors and non-survivors is crucial for improving care.
Purpose of the Study:
- To analyze the 2023 Nationwide Readmission Database (NRD) data.
- To identify predictors of in-hospital mortality in acute stroke patients.
- To compare baseline characteristics, comorbidities, and hospital factors between survivors and non-survivors.
Main Methods:
- Utilized International Classification of Diseases, 10th Revision (ICD-10) codes for patient identification.
- Excluded cases with missing data, December admissions, and 30-day readmissions.
- Employed multivariable logistic regression to assess mortality risk factors, adjusting for key patient and hospital variables.
Main Results:
- Non-survivors were older (median 73 vs. 71 years) and had a higher prevalence of comorbidities like cardiac arrest, heart failure, and respiratory failure.
- In-hospital mortality was associated with significantly higher costs ($122,763.67 vs. $56,497) and longer lengths of stay (7 vs. 4 days) for non-survivors.
- Admissions to large, private non-profit hospitals were associated with a higher proportion of non-survivors.
Conclusions:
- Advanced age, cardiovascular/metabolic comorbidities, and hospital resource use are key factors in stroke mortality.
- Early risk stratification and targeted interventions are essential for improving survival rates.
- Equitable healthcare access is critical for mitigating stroke mortality in high-risk populations.
Background:
Acute stroke (cerebral infarction) is a leading cause of morbidity and mortality worldwide, with patient outcomes influenced by demographic factors, comorbidities, and hospital characteristics. This study examines the differences in baseline characteristics, comorbidities, and hospital-related factors between survivors and non-survivors of acute stroke.
Methods:
This study analyzed the 2023 Nationwide Readmission Database (NRD) data to identify predictors of in-hospital mortality in acute stroke (cerebral infarction). Patients were identified using the International Classification of Diseases, 10th Revision (ICD-10) codes, and exclusions included missing data, December admissions, and 30-day readmissions. Multivariable logistic regression assessed mortality risk factors, adjusting for demographics, comorbidities, and hospital characteristics (p < 0.05).
Results:
Non-survivors had a significantly higher median age (73 years vs. 71 years, p < 0.001) and included a slightly higher proportion of women (48.8% vs. 47.2%, p < 0.001). The prevalence of comorbidities, including cardiac arrest (11.9% vs. 0.7%), heart failure (35.1% vs. 0.7%), and respiratory failure (71.2% vs. 11.7%), was markedly higher among non-survivors (p < 0.001 for all). Hospitalization costs were significantly greater for non-survivors ($122,763.67 vs. $56,497, p < 0.001), and the length of stay was longer (seven days vs. four days, p < 0.001). Most admissions occurred in private non-profit hospitals, with large hospitals treating a higher proportion of non-survivors (p < 0.001).
Conclusion:
The study highlights critical factors influencing stroke mortality, including advanced age, cardiovascular and metabolic comorbidities, and hospital resource utilization. These findings emphasize the need for early risk stratification, targeted intervention strategies, and equitable healthcare access to improve survival rates among high-risk stroke patients.
