Abstract TP199: Impact Of Dementia On In-hospital Outcomes Among Patients Admitted For Acute Stroke: Insights From The National Inpatient Sample Database

Introduction: Impact of Dementia on hospitalization metrics in acute stroke patients has not been thoroughly investigated. Methods: This cross-sectional analysis used the NIS database from 2018-2020. ICD-10-CM codes defined acute stroke as primary diagnosis and dementia as secondary diagnosis. Outcomes included in-hospital mortality, length of stay (LOS), inflation-adjusted total charges, and non-home discharges. Statistical models on R Statistical Language (v4.5.0) were used to depict associations between dementia and each outcome. In patients with dementia, we also evaluated the impact of stroke subtype [ischemic stroke (IS), intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH)] on outcomes. Results: Between 2018-2020, 1,899,015 acute stroke hospitalizations were identified; out of which 220,575 (11.6%) had coexisting dementia. When stratified by stroke type, IS (87%) was most common, followed by ICH (11%), and SAH (1.8%). Compared to stroke without dementia, former had lower odds of in-hospital mortality (OR = 0.83, 95% CI: 0.79–0.87, p<0.001), greater odds of non-home discharge (OR = 1.55, 95% CI: 1.52-1.59, p<0.001), longer median LOS (4.0 days, 95% CI: 3.0-7.0) and lower median total charges ($44,652, 95% CI: 26,531-78,877). Among dementia patients, IS group was associated with lower odds of in-hospital mortality (OR= 0.15, 95% CI: 0.14-0.15, p<0.001) and non-home discharge (OR= 0.32, 95% CI: 0.31-0.33, p<0.001), reduced LOS (β= -3.2, 95% CI: -3.3 to -3.1, p<0.001), and total charges (β= -48,850, 95% CI: -51,476 to -46,224). SAH group was associated with decreased odds of non-home discharge (OR= 0.62, 95% CI: 0.60-0.65, p<0.001), but increased LOS (β= 3.8, 95% CI: 3.6-4.1, p<0.001), and total hospital charges (β=152,127, 95% CI: 144,966-159,287, p<0.001), compared to ICH. Conclusion: Dementia significantly affects hospitalization outcomes in patients with acute stroke. It is associated with lower in-hospital mortality, however, leads to longer hospital stay, higher likelihood of non-home discharge, and reduced total hospital charges. Stroke subtype further influences these patterns. These associations are influenced by differences in management, discharge planning, and underlying health status, suggesting potential value of dementia-specific considerations in managing acute stroke patients to enhance care planning and resource allocation. Further studies are needed to assess long-term outcomes beyond hospitalization.