Decade-Long Nationwide Trends and Disparities in Use of Comfort Care Interventions for Patients With Ischemic Stroke

Authors

Kristie M Chu
Erica M Jones
Jennifer R Meeks
Alan P Pan
Kathryn L Agarwal
George E Taffet
Farhaan S Vahidy

Publication Date

4-20-2021

Journal

Journal of the American Heart Association

DOI

10.1161/JAHA.120.019785

PMID

33823605

PMCID

PMC8174182

PubMedCentral® Posted Date

4-7-2021

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Follow-Up Studies, Health Care Costs, Healthcare Disparities, Hospitalization, Humans, Inpatients, Ischemic Stroke, Male, Middle Aged, Patient Comfort, Retrospective Studies, Thrombolytic Therapy, Time Factors, United States, Young Adult, brain ischemia, comfort care, healthcare disparities, outcome assessment, services use, stroke, thrombolytic therapy, Ischemic Stroke, Cerebrovascular Disease/Stroke, Health Services, Cost-Effectiveness

Abstract

Background Stroke remains one of the leading causes of disability and death in the United States. We characterized 10-year nationwide trends in use of comfort care interventions (CCIs) among patients with ischemic stroke, particularly pertaining to acute thrombolytic therapy with intravenous tissue-type plasminogen activator and endovascular thrombectomy, and describe in-hospital outcomes and costs. Methods and Results We analyzed the National Inpatient Sample from 2006 to 2015 and identified adult patients with ischemic stroke with or without thrombolytic therapy and CCIs using validated