Introduction: Cerebrovascular disease is a leading cause of death and disability in the United States. Little is known about the overall burden of cerebrovascular disease across the healthcare system combined with mortality in the United States.
Methods: We used data on adults aged 35+ in the 2006 through 2014 Nationwide Emergency Department Sample (NEDS), National Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP), and the National Vital Statistics System (NVSS). Cerebrovascular disease was identified using the underlying cause of death in NVSS, and principal diagnoses in NEDS and NIS. The overall burden was estimated by obtaining mutually exclusive events with the total number of treat-and-release ED visits, non-fatal hospitalizations, and deaths. We calculated age-standardized cerebrovascular disease event rates using the year 2010 US Census population and relative percent change (RPC) to assess changes from 2006 to 2014.
Results: A total of 685,278 cerebrovascular disease events occurred in 2014 (Table). The age-standardized treat-and-release ED visit rate increased from 10.2 to 15.1/100,000 persons from 2006 to 2014 (RPC of 47%), while death rates decreased 18%. The total cerebrovascular disease event rate increased 12% among persons aged 35-54 from 2006 to 2014 and 2% among persons aged 55-64, while the rate decreased by about 12% among persons aged 65+. Among men aged 35-54, the rates increased from 104.5/100,000 in 2006 to 121.0/100,000 in 2014 (RPC 16%), increased 8% for women 35-54, and 6% for men 55-64 years old.
Conclusions: Our findings have important implications regarding rising cerebrovascular disease burden among adults aged 35-64 years. Focused prevention strategies should be implemented, especially among younger adults.