Abstract
Introduction: Ischemic cerebrovascular accidents (CVA) contribute to major morbidity in hospitalized patients. Little is known of its impact in Down Syndrome (DS) patients. Our aim was to characterize the patient demographic and to investigate the impact of CVA on hospitalized DS patients. Method: This was a retrospective cohort study utilizing 2019 National Inpatient Sample database. Adults with DS and CVA diagnoses were included. Regression models adjusted for demographic variables were used. Primary outcome was evaluating all-cause mortality, and secondary outcomes were evaluating length of stay (LOS) and total hospitalization charge. Results: Out of 44720 admissions with Down Syndrome, 355 had a ischemic cerebrovascular accident. Compared to Non-CVA-DS cohort, CVA-DS cohort were older (39.04 vs 24.71 years,p<0.001), more Black (19.72% vs 10.83%,p<0.05), Medicare (57.75% vs 35.03%,p<0.001), more hypertension (21.13% vs 6.16%,p<0.001), PVD (11.27% vs 1.75%,p<0.001), diabetes mellitus (18.31% vs 3.93%,p<0.001), but less Hispanic (9.86% vs 19.73%,p<0.05), private insurance (12.68% vs 23.96%,p<0.05), and West region hospital (11.27% vs 23.10%,p<0.05). There was no statistically significant difference in the prevalence of females, White, API, household income, hospital teaching status, dementia, chronic pulmonary disease, obesity, hypothyroidism. CVA-DS cohort had a similar all-cause mortality rate (3.19% vs 1.28%,p=0.1029), all-cause odds of mortality 1.48 (95%CI 0.39-5.63,p=0.563), mean LOS (9.79 vs 8.40 days,p=0.498), and mean total hospitalization charge ($172327.20 vs $99913.84,p=0.076). Conclusion: In patients admitted with DS, the presence of CVA was not associated with an increase in all-cause mortality, odds of mortality, mean LOS, or total charge, however it was associated with a higher prevalence in Black patients, older age, Medicare, hypertension, diabetes mellitus, and PVD, and a lower prevalence in Hispanic patients.
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