Abstract
Background and aims
Data on the economic impact of recurrent IS are limited. We evaluated length of stay (LoS) and all-cause costs to quantify the burden of recurrent IS following an index NCIS.
Methods
This retrospective cohort study utilised a nationwide hospital administrative database in Japan (Medical Data Vision Co., Ltd.). We included adults hospitalised for index NCIS between 01/01/15 and 30/04/22, with observability 365 days before and after index hospitalisation. LoS for any inpatient stay except where IS or TIA diagnoses were recorded (non-NCIS/TIA/IS) and all-cause costs were assessed during the 365-day post-discharge period. In a landmark analysis, patients without recurrent IS at Day 180 post-discharge were stratified by recurrent IS presence/absence during Days 181–360. Non-NCIS/TIA/IS LoS and all-cause costs between pre-landmark (Days 1–180) and post-landmark (Days 181–360) periods were compared.
Results
7,896 patients with index NCIS were included (mean age: 75.8 years, 45% female). One-year post-discharge, median LoS for non-NCIS/TIA/IS events was 18 days, with median all-cause costs being $32,632 (Figure). Analysis of the pre- to post-landmark period showed patients without recurrent IS had no increase in median non-NCIS/TIA/IS LoS or all-cause costs, whereas patients with recurrent IS had respective increases of 0 to 14 days and $7,417 to $21,024.
Conclusions
Patients with index NCIS and recurrent IS had longer LoS for non-NCIS/TIA/IS events and higher all-cause costs following recurrence versus pre-recurrence, highlighting the burden of recurrent IS and importance of secondary stroke prevention.
Conflict of interest
Funding for this study was provided by Bayer AG, Leverkusen, Germany. R.M. and T.H. declare honoraria from Bayer; M.T., S.O., L.B., J.X. and K.K. are Bayer employees and may own shares or share options in the company; C.L. and D.N. are Aetion, a Datavant company, employees; M.S. declares research funding and consultation fees for Bayer.
Figure 1 - belongs to Conclusions
