Background: As the prevalence of diabetes is increasing worldwide, our aim is to assess the recent cardiovascular and economic trend in outcomes of patients with stroke and diabetes in the U.S.

Methods: Data from the National Inpatient Sample was analyzed between 2005 to 2014. We studied: In-hospital mortality, length of stay (LoS) and overall hospital charges in patients hospitalized for stroke, >18 years of age and known to have diabetes.

Results: The prevalence of diabetes gradually increased from 28.2% to 35.5% in all patients hospitalized for stroke (p trend<0.001) between 2005 and 2014. In those patients with diabetes, mean (SD) age slightly decreased from 70 (13) years to 69 (13) years (p trend <0.001). Interestingly, hospitalization for stroke increased from 17.4 to 20.0/100 000 U.S. adults (p trend <0.001). However, in-hospital age-adjusted mortality decreased from 4.64% to 3.73% (p trend <0.001). Age-adjusted mortality of hemorrhagic strokes - which represent only a small proportion of all strokes- decreased from 28.1% to 23.1%, that of ischemic strokes decreased from 3.23% to 2.48% (p trend <0.01 for both) whereas that of TIA was almost stable and lower than 0.2%. As expected, total charges of hospital stay almost doubled as they went up from 15,970 to 31,018 USD/stay (adjusted for inflation). Nevertheless, median (IQR) LoS slightly decreased from 4 (2-6) to 3 (2-6) days (p trend <0.05).

Conclusion: Our preliminary data show that the prevalence of diabetes in patients hospitalized for stroke is gradually increasing. Moreover, hospitalization for stroke is also increasing. Nevertheless, in-hospital mortality is on a descending slope, which comes at a price of an almost 2-fold increase in hospital charges from 2005 to 2014.

Disclosure

A. Tabbalat: None. S.R. Dargham: None. M.B. Elshazly: Stock/Shareholder; Self; Ember Medical. C. Abi Khalil: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.