Abstract P429: Hospital Level Diagnostic Disparities of Cerebral Amyloid Angiopathy in the United States Nationwide Hospitalizations

Abstract

Background/Objective: There is limited knowledge of the nationwide prevalence of cerebral amyloid angiopathy (CAA) diagnosis and disparity amongst US hospitalization. The aim of this study is to assess the prevalence of CAA diagnosis and identify hospital-level disparity in the CAA diagnosis amongst US hospitalizations. Methods: A cross-sectional study was performed using the National Inpatient Sample [2016-2017] for adult hospitalizations. We extracted a cohort of patients with a diagnosis of CAA using ICD 10 code. Age was categorized as <50 years, 50-59, 60-69, 70-79, and ≥80 years. Weighted analysis using chi-square and multivariable survey logistic regression was performed to identify the prevalence of CAA and evaluate the diagnostic disparity of CAA amongst USA hospitalization. Results: Out of total 60,609,519 US hospitalizations, 16040 (0.027%) had a diagnosis of CAA. Patients with CAA were of higher age 71-80 years (39.9% vs 16.4%), ≥81 years (36.4% vs 14.9%), men (48.1% vs 42.1%), white (71.5% vs 67.5%), and more likely admitted to urban-teaching hospitals (83.9% vs 66.0%), Northeast region hospitals (26.5% vs 18.8%), and hospitals with large bed-size (65.7% vs 51.2%) compared to patients without CAA (p<0.0001). On regression analysis, urban non-teaching (aOR 2.1; 95%CI 1.6-2.9; ref=rural), urban-teaching hospitals [5.4 (4.1-7.2); ref=rural], median size hospital [1.3 (1.1-1.5); ref=small], and large bed size hospitals [2.3 (2-2.7); ref=small] had higher odds of diagnosis of CAA. Compared to the Northeast region, Midwest [0.8 (0.7-0.97)] and South [0.7 (0.6-0.8)] region hospitals had lower odds of a diagnosis of CAA. Conclusion: CAA was present in 0.03% of hospitalized patients in 2016-17. It was more commonly diagnosed in urban teaching, urban non-teaching, large and medium bed size hospitals compared to rural and small bed size hospitals. Lack of awareness of CAA diagnosis in rural and small hospitals could be a potential factor for these disparities.