AUTHOR=Chen Wei , Li Dong 

TITLE=Comorbidity and outcomes among hospitalized patients with stroke: a nationwide inpatient analysis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1217404

DOI=10.3389/fneur.2023.1217404

ISSN=1664-2295

ABSTRACT=Objective: We aimed to characterize healthcare utilization and comorbidity outcomes among hospitalized elderly stroke patients using a nationally representative dataset in the United States.
Methods: Using the 2019 National Inpatient Sample, patients aged 65 years or older hospitalized for acute stroke with and without comorbidities were identified using the International Classification of Diseases, Tenth Revision, Clinical Modification codes. Patient comorbidities was identified with use of the Elixhauser Comorbidity Index. The prevalence of comorbidities, in-hospital mortality, length of stay, and total hospital costs were analyzed for these patients.
Results: Within 451,945 patients (mean age 78 years, 54.1% women, 73.7% white), we observed that more than 90% of patients had a minimum of two comorbidities. The median number of comorbidities was 4.0 (IQR 3.0-6.0). There was significant variation in the prevalence rate of comorbidities. The five most commonly comorbidities were hypertension, uncomplicated (55.4%), paralysis (40.1%), congestive heart failure (39.8%), various neurological illnesses (38.3%), and hypertension, complex (32.5%). After adjusting for patient- and hospital-level characteristics, a statistically significant association was observed between comorbidities and various adverse outcomes. Specifically, comorbidities were found to be significantly associated with an increased risk of inpatient mortality, a longer duration of hospitalization, and higher total cost. 
Conclusions: This national data suggests that comorbidity is common among hospitalized older stroke patients and substantially increases the healthcare burden and inpatient mortality in the United States. These findings underscore the integration of comorbidity management into the care of older stroke patients.