Objectives: After a declined in mortality by 25.4% from 1996 to 2005, stroke became the fifth leading cause of death in men and the second leading cause of death in women. Stroke mortality decline in the past was mainly attributed to the improvement of stroke prevention. Stroke system of care has gone through evolutional changes in the past decade in both acute stroke treatment, preventing complications, identifying stroke etiology and stroke prevention. This study is to examine whether there was greater decline of mortality after ischemic stroke hospitalization from 2009 and 2013.
Methods: We examined the one-year mortality in Medicare beneficiaries aged ≥65 years who were hospitalized between January 1, 2009 and December 31, 2013 with a primary discharge diagnosis of ischemic stroke. The data of the patient information were obtained from the Medicare Provider Analysis and Review (MEDPAR) file. The list and characteristics of hospitals were obtained from the American Hospital Association Annual Survey Database. All statistical analyses were performed using SAS Version 9.4 software.
Results: A total of 1165,960 Medicare Beneficiaries was hospitalized for ischemic stroke between 2009 and 2013. The one-year mortality showed a steady declined by 17.6 % over the five years period. The one-year mortality declined by 17.4% in female, 17.8% in male, 17.0% in black,17.6 % in white, 22.6% in Hispanic, and 20.3% in Asian. Among the ten-year age group, people aged 65 to 74 years had the greatest decline in mortality, 22.5%, followed by 19.2% decline in the group 75 to 84 years, and 14.7% in the group 85 years and over.
Conclusion: The one-year mortality among Medicare beneficiaries after ischemic stroke hospitalization showed a dramatic decline from 2009 to 2013. Further study is needed to determine whether this is attributable to the change of stroke system of care in the past decade.