Abstract WMP93: Trends in Stroke Hospitalizations in California: 2005-2014

Abstract

Objectives: Little information is known about the recent trends of sex-, age-, race/ethnicity-, and stroke type-specific stroke hospitalizations in California. Understanding the information is important for the evaluation of regional health policies, healthcare planning and resource allocation, and stroke prevention strategies. The study reports statewide trends in hospitalization rates and mortality of stroke in California from 2005 to 2014. Methods: Adult patients admitted to California-licensed acute care hospitals for acute stroke from 2005 to 2014 were included in the study. Data were from the California patient discharge data. Sex-, age-, race/ethnicity- and stroke type-specific stroke hospitalization rates were calculated based on the California population. Results: Of 2,085,120 adult hospitalizations with stroke from 2005 to 2014, 831,236 patients were admitted for acute stroke. From 2005 to 2014, the overall stroke hospitalization rate decreased 9.7% (309.4 to 279.5 per 100,000). The decrease in hospitalization rates for women (14.0%) was significantly greater than that for men (4.8%). However, there was a significant increase of hospitalization rates in younger groups for both men and women, which was mainly driven by ischemic stroke: Men aged 18 to 34 years had the highest increase in ischemic stroke hospitalization rates (37.2%), followed by men aged 35 to 44 years (32.0%), aged 45 to 54 years (23.0%), and aged 55 to 64 years (12.1%), while men aged ≥ 65 years had a significant decrease (13.7%). Women had the similar, but less steep trend compared to men. Blacks had the highest hospitalization rates, followed by Whites and Asians. The rates decreased for Whites (12.4%), but increased for Native Americans (34.7%) over a decade. The overall in-hospital mortality rate decreased from 7.2% in 2005 to 6.1% in 2014; the decrease was not significantly different by sex, age (< 55 years) or stroke type. Conclusions: Overall California stroke hospitalization rates decreased from 2005 to 2014, but hospitalization rates for ischemic stroke increased, with a significant increase in younger groups. The trends of stroke hospitalization rates over the decade varied by sex, age, race/ethnicity and stroke type.