Background: We examined stroke-related hospitalizations and in-hospital mortality trends by sex and age in California from 2000 to 2013.
Methods: This retrospective analysis is based on data compiled by the California Office of Statewide Health and Planning Development from 2000 to 2013. Over 31.68 million inpatient events were studied, with cases from hospital discharge records identified as using the first listed diagnoses as ICD-9-CM codes 430 to 436. Hospitalization rates were expressed as the number of hospitalizations per 10,000 population and in-hospital mortality per 100,000 population, with the age and sex standardized to the year 2000 U.S. population.
Results: We identified 1,060,006 hospitalizations and 77,908 in-hospital mortalities that were stroke-related from 2000 to 2013.
Hospitalization rates standardized for age and sex, significantly declined from 56.15 in year 2000 to 37.17 in year 2013, representing a 51.1% reduction (Rate Ratio (RR) 1.511; p <0.0001) during the study period. Rates for males declined from 52.7 to 36.6, representing a 43.8% reduction (RR 1.438; p<0.0001) and rates for females changed from 59.2 to 37.6, representing a 57.4% reduction (RR 1.574; p<0.0001. Although rates are declining for most age groups, hospitalization rates are rising for males age 35 to 59.
In-hospital mortality rates standardized for age and sex, significantly declined from 43.0 in 2000 to 25.0 in 2013, representing a 70.0% reduction (Rate Ratio (RR) 1.700; p <0.0001). Statistically significant declines in stroke-related in-hospital mortality rates were greater among females at 80.1%, while for males the decline was 62.6%. Overall, the rate difference for stroke hospitalization and in-hospital mortality among males and females narrowed significantly from 2000 to 2013.
Conclusion: Stroke-related hospitalizations and in-hospital mortality declined substantially for both sexes, but at a greater rate among females over the 14 year study period. Although rates are declining overall for both sexes and most age groups, rates of stroke-related hospitalization and in-hospital mortality rose for males age 35 to 59.