Trends in Acute Ischemic Stroke Hospitalizations in the United States

Lucas Ramirez¹, May A Kim-Tenser², Nerses Sanossian³, Steven Cen⁴, Ge Wen⁵, Shuhan He⁵, William J Mack⁶, Amytis Towfighi⁷

Affiliations

¹ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA lucasram@usc.edu.
² Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California, Los Angeles, CA.
³ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California, Los Angeles, CA Department of Neurology, Rancho Los Amigos National Rehabilitation Center, Downey, CA.
⁴ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA Department of Neurosurgery, University of Southern California, Los Angeles, CA Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California, Los Angeles, CA.
⁵ Keck School of Medicine, University of Southern California, Los Angeles, CA.
⁶ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurosurgery, University of Southern California, Los Angeles, CA Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California, Los Angeles, CA.
⁷ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA Department of Neurology, Rancho Los Amigos National Rehabilitation Center, Downey, CA.

PMID: 27169548
PMCID: PMC4889194
DOI: 10.1161/JAHA.116.003233

Trends in Acute Ischemic Stroke Hospitalizations in the United States

Lucas Ramirez et al. J Am Heart Assoc. 2016.

. 2016 May 11;5(5):e003233.

doi: 10.1161/JAHA.116.003233.

Authors

Lucas Ramirez¹, May A Kim-Tenser², Nerses Sanossian³, Steven Cen⁴, Ge Wen⁵, Shuhan He⁵, William J Mack⁶, Amytis Towfighi⁷

Affiliations

¹ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA lucasram@usc.edu.
² Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California, Los Angeles, CA.
³ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California, Los Angeles, CA Department of Neurology, Rancho Los Amigos National Rehabilitation Center, Downey, CA.
⁴ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA Department of Neurosurgery, University of Southern California, Los Angeles, CA Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California, Los Angeles, CA.
⁵ Keck School of Medicine, University of Southern California, Los Angeles, CA.
⁶ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurosurgery, University of Southern California, Los Angeles, CA Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California, Los Angeles, CA.
⁷ Keck School of Medicine, University of Southern California, Los Angeles, CA Department of Neurology, University of Southern California, Los Angeles, CA Department of Neurology, Rancho Los Amigos National Rehabilitation Center, Downey, CA.

PMID: 27169548
PMCID: PMC4889194
DOI: 10.1161/JAHA.116.003233

Abstract

Background: Population-based studies have revealed declining acute ischemic stroke (AIS) hospitalization rates in the United States, but no study has assessed recent temporal trends in race/ethnic-, age-, and sex-specific AIS hospitalization rates.

Methods and results: Temporal trends in hospitalization for AIS from 2000 to 2010 were assessed among adults ≥25 years using the Nationwide Inpatient Sample. Age-, sex-, and race/ethnic-specific and age-adjusted stroke hospitalization rates were calculated using the weighted number of hospitalizations and US census data. From 2000 to 2010, age-adjusted stroke hospitalization rates decreased from 250 to 204 per 100 000 (overall rate reduction 18.4%). Age-specific AIS hospitalization rates decreased for individuals aged 65 to 84 years (846 to 605 per 100 000) and ≥85 years (2077 to 1618 per 100 000), but increased for individuals aged 25 to 44 years (16 to 23 per 100 000) and 45 to 64 years (149 to 156 per 100 000). Blacks had the highest age-adjusted yearly hospitalization rates, followed by Hispanics and whites (358, 170, and 155 per 100 000 in 2010). Age-adjusted AIS hospitalization rates increased for blacks but decreased for Hispanics and whites. Age-adjusted AIS hospitalization rates were lower in women and declined more steeply compared to men (272 to 212 per 100 000 in women versus 298 to 245 per 100 000 in men).

Conclusions: Although overall stroke hospitalizations declined in the United States, the reduction was more pronounced among older individuals, women, Hispanics, and whites. Renewed efforts at targeting risk factor control among vulnerable individuals may be warranted.

Keywords: acute ischemic stroke; hospitalization; nationwide inpatient sample; stroke; trends.

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Figures

**Figure 1**
Age‐adjusted acute ischemic stroke (AIS) hospitalization rates per 100 000 in the United States from 2000 to 2010.

**Figure 2**
Acute ischemic stroke (AIS) hospitalization rates by age category per 100 000 in the United States from 2000 to 2010.

**Figure 3**
Race‐specific age‐adjusted acute ischemic stroke (AIS) hospitalization rates per 100 000 in the United States from 2000 to 2010.

**Figure 4**
Sex‐specific age‐adjusted acute ischemic stroke (AIS) hospitalization rates per 100 000 in the United States from 2000 to 2010.

See this image and copyright information in PMC

Comment in

Rising Stroke Incidence in Young Adults: More Epidemiological Evidence, More Questions to Be Answered.
Béjot Y, Delpont B, Giroud M. Béjot Y, et al. J Am Heart Assoc. 2016 May 11;5(5):e003661. doi: 10.1161/JAHA.116.003661. J Am Heart Assoc. 2016. PMID: 27169549 Free PMC article. No abstract available.

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Trends in Acute Ischemic Stroke Hospitalizations in the United States

Affiliations

Trends in Acute Ischemic Stroke Hospitalizations in the United States

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