Additional Stroke-Related and Non-Stroke-Related Cardiovascular Costs and Hospitalizations in Managed-Care Patients After Ischemic Stroke

被引:13
作者
Roberts, Craig S. [1 ]
Gorelick, Philip B. [3 ]
Ye, Xin [2 ]
Harley, Carolyn [2 ]
Goldberg, George A.
机构
[1] Pfizer Inc, Global Outcomes Res, New York, NY 10017 USA
[2] i3 Innovus, Eden Prairie, MN USA
[3] Univ Illinois, Chicago, IL USA
关键词
stroke; health cafe costs; hospitalization; risk factors; managed cafe; MYOCARDIAL-INFARCTION; NORTHERN MANHATTAN; RECURRENT STROKE; VASCULAR DEATH; ATTACK; RISK; ASSOCIATION; PROFESSIONALS; PREVENTION; GUIDELINES;
D O I
10.1161/STROKEAHA.108.534354
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose-Prior stroke confers an increased risk of future cardiovascular events. Because the incremental economic impact of this added risk is unknown, we assessed the additional cardiovascular costs and hospitalizations associated with ischemic stroke. Methods-Patients hospitalized for ischemic stroke during 2002 to 2005 were identified from a large US managed-care plan and matched to control patients hospitalized for a noncardiovascular acute event. Cumulative stroke-related and non-stroke-related cardiovascular medical costs were determined for each group. Stroke and nonstroke cardiovascular hospitalization rates were calculated with the Kaplan-Meier method; risk of hospitalization was estimated with a Cox regression model. Results-Stroke patients and matched controls (N=11 883) were identified (mean age approximate to 58 years; 47.8% female). Compared with controls, patients hospitalized for ischemic stroke had higher stroke and nonstroke cardiovascular medical costs at 6 months (stroke: $1756 vs $50, P<0.01; nonstroke cardiovascular: $1437 vs $658, P<0.01) and 12 months (stroke: $2109 vs $68, P<0.01; nonstroke cardiovascular: $2203 vs $1167, P<0.01) of follow-up. Among stroke patients, cumulative stroke and nonstroke cardiovascular hospitalization rates were 9.06% and 5.63% at 6 months, respectively, and 21.09% and 22.05% at 36 months, respectively. Stroke patients were at significantly increased risk of repeat stroke hospitalization (hazard ratio=12.55; 95% CI, 10.50 to 15.01) and nonstroke cardiovascular hospitalization (hazard ratio=1.95; 95% CI, 1.77 to 2.14). Conclusions-After ischemic stroke, patients have significantly greater stroke and nonstroke cardiovascular costs and hospitalizations than do matched controls. Attention to total cardiovascular risk reduction in this population could potentially reduce downstream costs. (Stroke. 2009;40:1425-1432.)
引用
收藏
页码:1425 / 1432
页数:8
相关论文
共 11 条
  • [1] Coronary risk evaluation in patients with transient ischemic attack and ischemic stroke - A scientific statement for healthcare professionals from the stroke council and the council on clinical cardiology of the American Heart Association/American Stroke Association
    Adams, RJ
    Chimowitz, MI
    Alpert, JS
    Awad, IA
    Cerqueria, MD
    Fayad, P
    Taubert, KA
    [J]. CIRCULATION, 2003, 108 (10) : 1278 - 1290
  • [2] Update to the AHA/ASA recommendations for the prevention of stroke in patients with stroke and transient ischemic attack
    Adams, Robert J.
    Albers, Greg
    Alberts, Mark J.
    Benavente, Oscar
    Furie, Karen
    Goldstein, Larry B.
    Gorelick, Philip
    Halperin, Jonathan
    Harbaugh, Robert
    Johnston, S. Claiborne
    Katzan, Irene
    Kelly-Hayes, Margaret
    Kenton, Edgar J.
    Marks, Michael
    Sacco, Ralph L.
    Schwamm, Lee H.
    [J]. STROKE, 2008, 39 (05) : 1647 - 1652
  • [3] Recurrent stroke risk is higher than cardiac event risk after initial stroke/transient ischemic attack
    Brown, DL
    Lisabeth, LD
    Roychoudhury, C
    Ye, YN
    Morgenstern, LB
    [J]. STROKE, 2005, 36 (06) : 1285 - 1287
  • [4] Risk of myocardial infarction or vascular death after first ischemic stroke - The northern Manhattan study
    Dhamoon, Mandip S.
    Tai, Wanling
    Boden-Albala, Bernadette
    Rundek, Tanja
    Paik, Myunghee C.
    Sacco, Ralph L.
    Elkind, Mitchell S. V.
    [J]. STROKE, 2007, 38 (06) : 1752 - 1758
  • [5] Recurrent stroke and cardiac risks after first ischemic stroke - The Northern Manhattan Study
    Dhamoon, MS
    Sciacca, RR
    Rundek, T
    Sacco, RL
    Elkind, MSV
    [J]. NEUROLOGY, 2006, 66 (05) : 641 - 646
  • [6] Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines
    Grundy, SM
    Cleeman, JI
    Merz, CNB
    Brewer, HB
    Clark, LT
    Hunninghake, DB
    Pasternak, RC
    Smith, SC
    Stone, NJ
    [J]. CIRCULATION, 2004, 110 (02) : 227 - 239
  • [7] Heart disease and stroke statistics - 2008 update - A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee
    Rosamond, Wayne
    Flegal, Katherine
    Furie, Karen
    Go, Alan
    Greenlund, Kurt
    Haase, Nancy
    Hailpern, Susan M.
    Ho, Michael
    Howard, Virginia
    Kissela, Bret
    Kittner, Steven
    Lloyd-Jones, Donald
    McDermott, Mary
    Meigs, James
    Moy, Claudia
    Nichol, Graham
    O'Donnell, Christopher
    Roger, Veronique
    Sorlie, Paul
    Steinberger, Julia
    Thom, Thomas
    Wilson, Matt
    Hong, Yuling
    [J]. CIRCULATION, 2008, 117 (04) : E25 - E146
  • [8] Sacco RL, 2006, STROKE, V37, P577, DOI 10.1161/01.STR.0000199147.30016.74
  • [9] Lifetime cost of stroke in the United States
    Taylor, TN
    Davis, PH
    Torner, JC
    Holmes, J
    Meyer, JW
    Jacobson, MF
    [J]. STROKE, 1996, 27 (09) : 1459 - 1466
  • [10] Risk of myocardial infarction and vascular death after transient ischemic attack and ischemic stroke -: A systematic review and meta-analysis
    Touzé, E
    Varenne, O
    Chatellier, G
    Peyrard, S
    Rothwell, PM
    Mas, JL
    [J]. STROKE, 2005, 36 (12) : 2748 - 2755