Abstract 21112: Trends in Acute Ischemic Stroke Admissions in Patients With Atrial Fibrillation and Flutter From 2004 to 2014

Abstract

Introduction: Atrial Fibrillation and Flutter (AF) predispose patients to acute ischemic strokes and increased mortality. We aim to assess the impact of new guidelines, innovations in technology and several new drugs on mortality and morbidity of patients hospitalized for ischemic stroke with concurrent AF over 10 years. We assessed the hypothesis that these advances would be associated with improvements in mortality over that time period. Methods: This is a retrospective cohort study using the 2004-2014 National Inpatient Sample, the largest publicly available inpatient database in the United States. We included women and men >18 years of age admitted between 2004 and 2014 with primary diagnoses of atrial fibrillation or flutter and with secondary diagnoses of acute ischemic stroke and transient ischemic attack (using ICD-9 CM codes). The primary outcome was in-hospital mortality and the secondary outcomes were total hospital cost and mean length of stay (LOS). STATA 13.0 was used for data analysis. Results: 222,074 patients were included in this study. The mean age was 79.2 years and 58.8% were female. The inpatient mortality rate in 2004 was 11.6% and it decreased consistently until 2014 at 8.0% (p trend <0.001). Mean total hospital cost was $10,582 in 2004 and it increased consistently until 2014 at $13,849 (p trend < 0.001). Mean length of stay steadily decreased from 6.9 days in 2004 to 5.7 days in 2014. Conclusion: Over the past 10 years, new innovations in technology and the approval and use of several novel oral anticoagulants for use in AF have been implemented. While there is a trend of increasing costs, these measures seem to show a trend of improving mortality and decreasing length of stay in patients hospitalized with ischemic strokes and AF.