Abstract TMP52: The Hidden Burden of Ischemic Stroke, Transient Ischemic Attack, and Atrial Fibrillation Hospitalizations Among Elderly Women

Abstract

Background: US women have a greater lifetime risk of stroke than men. Risk factors such as pregnancy and hormones influence sex differences in stroke at younger ages, but less is known about hospitalization rates and the proportion of hospitalizations for ischemic stroke (IS), transient ischemic attack (TIA), and atrial fibrillation (AF) by sex in different age groups. We assessed IS, TIA, and AF hospitalizations by sex and age. Methods: IS (ICD-9 433, 434, 436), TIA (435), and AF (427.31) hospitalizations were identified in the 2014 National Inpatient Sample (NIS). Hospitalization rates per 100,000 population aged ≥18y were calculated using age- and sex-specific Census population denominators and NIS sampling weights to obtain national estimates. We also determined the proportions of condition-specific hospitalizations by sex. Results: There were 338,654 (49.8% women) patients hospitalized for IS, 90,812 (58.0% women) for TIA, and 284,770 (49.9% women) for AF. For IS, TIA, and AF, respectively, the mean ages for women were 72.7y, 71.4y, and 74.0y vs 68.8y, 69.1y, and 66.2y for men. Hospitalization rates were higher for men than women at most ages for IS and AF; however, AF rates were higher in women beginning with age 80-84y (figure). Women represented a greater proportion of hospitalizations among those aged ≥75y for all 3 conditions (58% of IS, 62.5% of TIA, and 64.7% of AF events). The proportion of women hospitalized for TIA was higher in most age groups, but for IS and AF, the proportions of women exceeded those of men beginning at ages 75-80y and 70-75y, respectively. Conclusion: Women were older when hospitalized for IS, TIA, and AF, and women aged ≥75y comprised the majority of these hospitalizations. This highlights the need for early detection of AF and IS risk in elderly women and underscores the importance of treating modifiable conditions to decrease the burden of vascular illness in women. This is critical given the overrepresentation of women among the very elderly.