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Stroke severity, subsequent events predicted long-term hospital costs
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Long-term hospital costs after transient ischemic attack or stroke are significant, especially during the first year after the event, and are largely influenced by stroke severity, recurrent stroke and coronary events, according to data from the Oxford Vascular Study.
Researchers evaluated data from patients enrolled in the United Kingdom population-based cohort study who were recruited from 2002 to 2007. They evaluated hospital resource usage, which was obtained from patient hospital records and valued using 2008/2009 unit costs, at 1- and 5-year follow-up. The researchers used nonparametric censoring techniques for analysis because 5-year follow-up data were not available for all patients.
Of those included in the study, 485 and 729 patients experienced TIA and stroke, respectively. Mean censor-adjusted 5-year hospital costs after index stroke were $25,741 (95% CI, 23,659-27,914). These expenses ranged considerably according to event severity, the researchers wrote, with costs of $21,134 after minor stroke, $33,119 after moderate stroke and $28,552 after severe stroke.
Among the 239 patients who completed 5-year follow-up, mean costs were $24,383 (95% CI, 20,156-28,595). More than half of these costs ($12,972), the researchers said, were incurred during the first year after the index event.
Event severity, recurrent stroke and coronary events after the initial stroke or TIA were identified as independent predictors of 5-year costs, according to a multivariate analysis. Stroke severity and subsequent events also explained most differences in stroke subtype.
“Our results highlight the importance of initial stroke severity as a predictor of costs. This study should be of use to analysts assessing the burden of TIA and stroke and the long-term cost-effectiveness of interventions for prevention and treatment of these two conditions, especially when extrapolating short-term results from clinical trial follow-up,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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