Factors Associated With Length of Hospitalization in Patients Admitted With Transient Ischemic Attack in United States

Qureshi, Adnan I.; Adil, Malik M; Zacharatos, Haralabos; Suri, M. Fareed K.

doi:10.1161/strokeaha.111.000590

Cited by 31 publications

(23 citation statements)

References 19 publications

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“…In the Netherlands, the LOS was the same, but the costs were higher (US$3,474) 16 . In the USA, the LOS was also the same but the costs were even higher (US$16,450) 26 . In this USA study, the author reported that the treatment of TIA comorbidities, the characteristics of hospitals and health insurance increased the LOS and cost of hospitalization.…”

Section: Discussionmentioning

confidence: 89%

The cost of stroke in private hospitals in Brazil: a one-year prospective study

Vieira¹,

Safanelli

Araujo³

et al. 2019

Arq. Neuro-Psiquiatr.

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Few studies from low- and middle-income countries have assessed stroke and cerebral reperfusion costs from the private sector. Objective To measure the in-hospital costs of ischemic stroke (IS), with and without cerebral reperfusion, primary intracerebral hemorrhage (PIH), subarachnoid hemorrhage (SAH) and transient ischemic attacks (TIA) in two private hospitals in Joinville, Brazil. Methods Prospective disease-cost study. All medical and nonmedical costs for patients admitted with any stroke type or TIA were consecutively determined in 2016-17. All costs were adjusted to the gross domestic product deflator index and purchasing power parity. Results We included 173 patients. The median cost per patient was US$3,827 (IQR: 2,800-8,664) for the 131 IS patients; US$2,315 (IQR: 1,692-2,959) for the 27 TIA patients; US$16,442 (IQR: 5,108-33,355) for the 11 PIH patients and US$28,928 (IQR: 12,424-48,037) for the four SAH patients (p < 0.00001). For the six IS patients who underwent intravenous thrombolysis, the median cost per patient was US$11,463 (IQR: 8,931-14,291), and for the four IS patients who underwent intra-arterial thrombectomy, the median cost per patient was US$35,092 (IQR: 31,833-37,626; p < 0.0001). A direct correlation was found between cost and length of stay (r = 0.67, p < 0.001). Conclusions Stroke is a costly disease. In the private sector, the costs of cerebral reperfusion for IS treatment were three-to-ten times higher than for usual treatments. Therefore, cost-effectiveness studies are urgently needed in low- and middle-income countries.

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Section: Discussionmentioning

confidence: 89%

The cost of stroke in private hospitals in Brazil: a one-year prospective study

Vieira¹,

Safanelli

Araujo³

et al. 2019

Arq. Neuro-Psiquiatr.

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“…A prospective analysis of 515 stroke patients (Copenhagen Stroke Study), showed that outcome measures such as the activities of daily living (measured by the Barthel Index [BI]) were significantly worse in older patients, although neurological outcomes were not affected by age (Nakayama et al 1994), suggesting a poorer ability to compensate among this older population. Furthermore, hospitalization length was significantly increased in older patients (>65 yrs) with stroke (Qureshi et al 2013). Observational studies in university-hospital settings reported that age was a highly significant predictor of poor functional outcome (Knoflach et al 2012, Denti et al 2010, Abanto et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Age-related changes in brain support cells: Implications for stroke severity

Sohrabji

Bake

Lewis

2013

Neurochemistry International

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Stroke is one of the leading causes of adult disability and the fourth leading cause of mortality in the US. Stroke disproportionately occurs among the elderly, where the disease is more likely to be fatal or lead to long-term supportive care. Animal models, where the ischemic insult can be controlled more precisely, also confirm that aged animals sustain more severe strokes as compared to young animals. Furthermore, the neuroprotection usually seen in younger females when compared to young males is not observed in older females. The preclinical literature thus provides a valuable resource for understanding why the aging brain is more susceptible to severe infarction. In this review, we discuss the hypothesis that stroke severity in the aging brain may be associated with reduced functional capacity of critical support cells. Specifically, we focus on astrocytes, that are critical for detoxification of the brain microenvironment and endothelial cells, which play a crucial role in maintaining the blood brain barrier. In view of the sex difference in stroke severity, this review also discusses studies of middle-aged acyclic females as well as the effects of the estrogen on astrocytes and endothelial cells

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“…It is also interesting to compare the costs of psychiatric hospitalization to those for common general medical disorders. For example, recent cost-estimates of hospitalization for stroke have averaged 21.8 (CI: 4.70-39.0), and for a heart attack or comparable cardiac illness, 27.3 (8.75-35.8) thousands of US dollars, or 2.3-2.9-times more than the average cost of psychiatric hospitalization at the present study site, 9.50 (8.86-10.1) [58][59][60].…”

Section: Discussionmentioning

confidence: 63%