Hospitalization expenses of acute ischemic stroke patients with atrial fibrillation relative to those with normal sinus rhythm

Abstract

Background and objective: Atrial fibrillation (AF) is a risk factor for acute ischemic stroke (AIS). In mainland China, little is known of the hospitalization expenses of AIS patients with AF compared to those with normal sinus rhythm (SR). This study compared the itemized expenses of AIS patients with or without AF in a hospital in Huizhou City.

Methods: Patients hospitalized for AIS from March 2014 to March 2015 were enrolled, including 73 with AF and 751 with normal SR. Stroke severity was scored using the National Institutes of Health Stroke Scale (NIHSS). Non-parametric statistical tests were used to determine differences in hospital expenses between the two groups, of which influencing factors were analyzed using single factor and multiple stepwise linear regression analyses.

Results: Medicine was the predominant expense during hospitalization of all AIS patients. Patients with AF incurred significantly higher expenses for medicine, bed, treatments, examinations, laboratory tests, and nursing than patients with normal SR (p < .05); however, the medicine and bed expenses of patients at the same stroke level in the two groups were similar. Independent factors influencing the higher costs of AF patients were hospital length of stay, pulmonary infection, urinary-tract infection, NIHSS scoring, gastrointestinal bleeding, and congestive heart failure (p < .05). Independent predictors of hospital length of stay were NIHSS scoring, pulmonary infection, and urinary-tract infection (p < .05).

Conclusion: AIS patients with AF incurred higher expenses during hospitalization compared with those with normal SR, due to greater stroke severity, higher rates of pulmonary infection and congestive heart failure, and longer hospital stays.

Keywords:

• Acute ischemic stroke
• Atrial fibrillation
• Hospital expense
• Anticoagulant therapy

Transparency

Declaration of funding

This study was not financially supported by any institution or sponsor.

Declaration of financial/other relationships

The authors report no conflicts of interst. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

This study was conducted according to the Ministry of Health “Involves people of biomedical research ethics review method (trial) (2007)”, and performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. In this study the subjects’ rights and interests are fully protected.