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Abstract
Objective To test the hypothesis that the prevalence of cervical artery dissection remains constant across age groups, we evaluated the relationship between age and cervical artery dissection in patients with stroke using a nationally representative sample from the United States.
Methods We used inpatient claims data included in the 2012–2015 releases of the National Inpatient Sample (NIS). We used validated ICD-9-CM codes to identify adults hospitalized with ischemic stroke and a concomitant diagnosis of carotid or vertebral artery dissection. Survey weights provided by the NIS and population estimates from the US census were used to calculate nationally representative estimates. The χ2 test for trend was used to compare the prevalence of concomitant dissection among stroke hospitalizations across patient subgroups defined by age. Poisson regression and the Wald test for trend were used to evaluate whether the prevalence of hospitalizations for stroke and concomitant dissection per million person-years varied by age groups.
Results There were 17,320 (95% confidence interval [CI], 15,614–19,026) hospitalizations involving ischemic stroke and a concomitant dissection. The prevalence of dissection among stroke hospitalizations decreased across 10-year age groups from 7.2% (95% CI, 6.2%–8.1%) among persons younger than 30 years to 0.2% (95% CI, 0.1%–0.2%) among persons older than 80 years (p value for trend <0.001). However, the prevalence of hospitalizations for stroke and concomitant dissection increased from 5.4 (95% CI, 4.6–6.2) hospitalizations per million person-years among adults younger than 30 to 24.4 (95% CI, 21.0–27.9) hospitalizations per million person-years among adults older than age 80 (p value for trend <0.01).
Conclusion In a nationally representative sample, the prevalence of hospitalizations for dissection-related stroke increased with age.
Glossary
- CAESAR=
- Cornell Acute Stroke Academic Registry;
- CI=
- confidence interval;
- ICD-9-CM=
- International Classification of Diseases, 9th Revision, Clinical Modification;
- NIS=
- National Inpatient Sample
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
CME Course: NPub.org/cmelist
- Received June 22, 2020.
- Accepted in final form October 14, 2020.
- © 2021 American Academy of Neurology
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