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

Figures & data

Table 1. Demographic and clinical characteristics of the patients.

	All patients	Group A	Group S	p-value
Subjects, n	824	73	751	–
Female patients, %	36.20%	50.70%	34.80%	.01
Hospitalization, days	11.5 ± 9.3	14.9 ± 11.8	11.2 ± 8.9	.006
Age, years	65 ± 12	70 ± 12	64 ± 12	<.001
NIHSS score	6 ± 5	12 ± 8	6 ± 5	<.001
Stroke severity, %
Mild	73.05%	38.36%	77.00%	<0.001
Moderate	17.11%	24.66%	16.42%	–
Severe	9.30%	37.00%	6.70%	–
Hypertension	68.40%	52.10%	70.00%	.002
Diabetes mellitus	26.30%	19.20%	27.00%	.165
Pulmonary infection	17.11%	36.99%	15.29%	<.001
Urinary infection	3.80%	4.10%	3.70%	.75
Congestive cardiac failure	8.70%	61.60%	3.60%	<.001
Chronic kidney disease	10.20%	9.59%	10.30%	>.999
GI hemorrhage	0.92%	1.40%	0.90%	.525
Hyperlipidemia	14.90%	11.00%	15.30%	.391
Hyperuricemia	5.00%	4.10%	5.10%	.088

NIHSS, National Institutes of Health Stroke Scale; GI, gastrointestinal.

Figure 1. Percentage of direct-cost components for patients with AF (Group A) or without AF (Group S). AF, atrial fibrillation; ECG, electrocardiogram; CT, computed tomography; MRI, magnetic resonance imaging.

Table 2. Hospitalization expenses of patients.*

	Stroke severity	Group S	Group A	All patients	p-value
Subjects		824	73	751	–
Medicine	Mild	1,000.33 ± 604.34	1,090.64 ± 662.97	1,004.51 ± 606.87	.509
	Moderate	1,637.93 ± 1,260.93	2,696 ± 2,544.79	1,773 ± 1,515.74	.63
	Severe	3,145.76 ± 2,507.24	2,785.16 ± 2,198.77	3,019.32 ± 2,395.19	.654
	Total	1,247.6 ± 1,123.66	2,113.22 ± 2,024.98	1,324.29 ± 1,252.97	.001
Bed	Mild	55.62 ± 40.58	66.1 ± 38.05	56.11 ± 40.49	.065
	Moderate	96.87 ± 89.16	170.81 ± 203.19	106.31 ± 112.04	.729
	Severe	192.02 ± 167.2	148.85 ± 111.54	176.88 ± 150.7	.399
	Total	71.46 ± 75.2	122.53 ± 129.86	75.98 ± 82.7	.001
Consultation	Mild	5.45 ± 4.04	6.45 ± 3.27	5.5 ± 4.01	.031
	Moderate	9.16 ± 7.19	12.7 ± 11.79	9.61 ± 7.96	.632
	Severe	13.96 ± 10.69	10.64 ± 7.37	12.8 ± 9.73	.249
	Total	6.63 ± 5.84	9.54 ± 7.94	6.89 ± 6.1	<.001
Examination	Mild	16.27 ± 57.52	33.14 ± 80.3	17.05 ± 58.78	.309
	Moderate	59.46 ± 168.83	221.03 ± 256.41	80.09 ± 189.07	<.001
	Severe	310.66 ± 354.01	324.62 ± 276.63	315.55 ± 327.15	.305
	Total	42.94 ± 144.02	187.28 ± 249.34	55.73 ± 161.32	<.001
X ray	Mild	15.01 ± 11.15	17.07 ± 19.74	15.1 ± 11.67	.786
	Moderate	15.06 ± 11.46	16.72 ± 15.27	15.27 ± 11.96	.962
	Severe	15.89 ± 13.3	19.02 ± 16.34	16.99 ± 14.41	.574
	Total	15.08 ± 11.34	17.71 ± 17.28	15.31 ± 11.99	.792
Ultrasonic	Mild	74.05 ± 39.73	78.88 ± 30.91	74.28 ± 39.35	.43
	Moderate	77.92 ± 44.03	76.38 ± 43.01	77.73 ± 43.75	.848
	Severe	81.2 ± 74.94	88.73 ± 64.77	83.84 ± 71.2	.397
	Total	75.16 ± 43.6	81.91 ± 48.36	75.76 ± 44.05	.241
ECG	Mild	7.22 ± 12	15.06 ± 19.16	7.58 ± 12.51	.001
	Moderate	6.65 ± 7.61	11.22 ± 11.93	7.23 ± 8.37	.016
	Severe	10.66 ± 16.7	16.31 ± 20.38	12.64 ± 18.14	.343
	Total	7.35 ± 11.8	14.58 ± 18.04	7.99 ± 12.64	<.001
Oxygen	Mild	6.96 ± 34.02	15.23 ± 40.39	7.35 ± 34.34	.092
	Moderate	31.84 ± 82.93	145.4 ± 207.2	46.33 ± 112.49	<.001
	Severe	147.73 ± 165.96	177.51 ± 124.9	158.18 ± 152.64	.102
	Total	20.41 ± 71.06	107.35 ± 147.95	28.11 ± 84.43	<.001
Laboratory tests	Mild	174.67 ± 132.47	241.96 ± 170.94	177.78 ± 135.06	.002
	Moderate	247.68 ± 254.11	442.89 ± 384.7	272.6 ± 280.2	.005
	Severe	508.32 ± 390.11	560.46 ± 356.01	526.6 ± 376.97	.276
	Total	208.84 ± 202.67	409.31 ± 333.78	226.6 ± 224.56	<.001
Nursing care	Mild	158.42 ± 287.24	181.24 ± 305.96	159.47 ± 287.9	.692
	Moderate	485.7 ± 717.49	957.47 ± 1,148.86	545.92 ± 796.14	.387
	Severe	1,192.71 ± 1,117.11	1,005.14 ± 784.87	1,126.94 ± 1,011.65	.631
	Total	280.88 ± 550.1	677.37 ± 851.36	316.01 ± 593.2	<.001
Procedures	Mild	1.08 ± 6.53	2.08 ± 10.98	1.13 ± 6.79	.786
	Moderate	1.58 ± 6.75	1.28 ± 3.65	1.54 ± 6.42	.537
	Severe	16.02 ± 97.54	6.25 ± 26.47	12.6 ± 79.98	.728
	Total	2.16 ± 25.99	3.42 ± 17.5	2.27 ± 25.35	.035
CT	Mild	218.77 ± 196.54	156.48 ± 168.13	215.89 ± 195.63	.157
	Moderate	200 ± 185.73	225.79 ± 196.12	203.29 ± 186.56	.439
	Severe	233.56 ± 208.45	205.62 ± 178.75	223.77 ± 197.8	.803
	Total	216.68 ± 195.54	191.75 ± 179.07	214.47 ± 194.16	.631
MRI	Mild	142.26 ± 80	113.48 ± 87.52	140.93 ± 80.51	.331
	Moderate	137.83 ± 79.08	114.29 ± 84.99	134.83 ± 79.93	.207
	Severe	127.3 ± 87.45	125.56 ± 83.99	126.69 ± 85.7	.97
	Total	140.54 ± 80.35	118.15 ± 84.6	138.56 ± 80.93	.205
Blood products	Mild	5.37 ± 103.26	0 ± 0	5.12 ± 100.85	.621
	Moderate	12.9 ± 72.19	0 ± 0	11.26 ± 67.53	.386
	Severe	0 ± 0	0 ± 0	0 ± 0	>.999
	Total	6.24 ± 95.19	0 ± 0	5.69 ± 90.89	.322
Total	Mild	1,881.5 ± 1,094.64	2,017.82 ± 1,251.87	1,887.8 ± 1,101.61	.713
	Moderate	3,020.58 ± 2,494.74	5,092 ± 4,627.33	3,285.02 ± 2,916.3	.481
	Severe	5,995.8 ± 4,714.54	5,473.88 ± 3,883.11	5,812.79 ± 4,421.74	.79
	Total	2,341.98 ± 2,124.94	4,054.11 ± 3,704.88	2,493.66 ± 2,356.41	<.001

* Calculated in Chinese Yuan (CNY) and reported in USD, dollars (exchange rate: 1 US$ = 6.2122 CNY; March 30, 2014).

ECG, electrocardiogram; CT, computed tomography; MRI, magnetic resonance imaging, CNY, Chinese Yuan.

Table 3. Univariate analysis of hospital costs and hospital stay, correlation coefficients, r (p).

	Total costs, r (p)	Hospital stay duration, r (p)
Hospitalization	.77 (<.001)	–
Age	.06 (.11)	.08 (.03)
NIHSS	.36 (<.001)	.32 (<.001)
AF	.13 (<.001)	.1 (.01)
Diabetes mellitus	.06 (.07)	0 (.89)
Pulmonary infection	.29 (<.001)	.2 (<.001)
Hypertension	.01 (.67)	.05 (.17)
Urinary infection	.05 (.19)	.11 (<.001)
Congestive cardiac failure	.23 (<.001)	.17 (<.001)
Chronic kidney disease	.11 (<.001)	.07 (.04)
GI hemorrhage	.08 (.02)	.07 (.03)
Hyperlipidemia	0 (1.00)	–.02 (.52)
Hyperuricemia	–0.02 (.5)	–.04 (.22)

NIHSS, National Institutes of Health Stroke Scale; AF, atrial fibrillation; GI, gastrointestinal.

Table 4. Multivariate analysis of hospital costs and length of stay.

	Non-STD coef.		STD coef.	p*	R	R^2	Adj. R^2	SE
	β	SD
Hospital expenses
Constant	8.740	.023	–	<.001	.805	.648	.645	.375
Hospital stay	.045	.002	.664	<.001
NIHSS	.017	.003	.150	<.001
Pulmonary infection	.205	.038	.123	<.001
Congestive cardiac failure	.122	.051	.055	.016
Urinary infection	−.188	.070	−.057	.007
GI hemorrhage	.330	.135	.051	.014
Hospitalization
Constant	2.017	.029	–	<.001	.373	.139	.136	.540
NIHSS	.029	.004	.280	<.001
Pulmonary infection	.235	.052	.153	<.001
Urinary infection	.210	.100	.069	.036

* The financial and time data were logarithmically transformed before undergoing stepwise multiple regressions to determine the independent predictors of hospital expenses and stay. The inclusive standard of multivariate analysis was p < .05.

Adj., adjusted; coef., coefficient; SE, standard error; STD, standardized; NIHSS, National Institutes of Health Stroke Scale; GI, gastrointestinal.