Abstract 4366435: Disparity in Stroke-Related Hospitalizations in the United States (2008–2020): A Nationwide Analysis by Demographics and Region

Abstract

Background: Stroke is one of the leading causes of long-term disability and mortality in the United States. While clinical care has improved, the demographic and regional shifts in stroke-related hospitalizations over the past decade remain poorly characterized, particularly in the context of evolving population health disparities. Objective: To examine national trends in stroke-related hospital admissions from 2008 to 2020, stratified by gender, race, age group, geographic region, and in-hospital mortality. Methods: We used data from the National Inpatient Sample (NIS) from 2008 to 2020 to identify stroke-related hospital admissions using relevant ICD-9 and ICD-10 codes. Sampling weights were applied to produce nationally representative estimates. Descriptive statistics were computed using chi-square tests for categorical variables and t-tests for continuous variables, considering the complex survey design. To assess trends over time, we conducted linear trend analyses stratified by age, sex, race/ethnicity, and U.S. Census region. The Cochran-Armitage trend test was used to evaluate temporal trends across stratified subgroups. Results: A total of 8.7 million stroke hospitalizations were recorded from 2008 to 2020, with a significant increase over time ( p < 0.01 ). Over the decade, stroke-related hospital admissions increased for both sexes ( p < 0.01 ), with a steeper rise observed among males. Male admissions rose 47.3% ( p < 0.01 ) while female admissions increased 18.1% ( p < 0.01 ) ( Fig 1 ). While non-Hispanic Whites comprised most cases, larger relative increases were observed among Black, Hispanic, and Asian populations ( p < 0.01 ). Age-wise, the 26-40 and 41–64 groups experienced the sharpest increases ( p < 0.01 ), while the 18–25 group saw a smaller yet notable 17.3% rise . Although adults aged 65 and above carried the highest absolute burden, their relative increase was more modest. Regionally, hospitalizations increased significantly across all areas: South (32.1%), West (45.4%) , Northeast (27.2%) , and Midwest (23.0%) ( all p < 0.01 ) (Fig 2) . Lastly, stroke-related in-hospital mortality rose by 18.6% over the study period ( p < 0.01 ) ( Fig 3 ). Conclusion: Stroke-related hospitalizations in the U.S. have increased significantly, with notable disparities by age, race, and region. The rising burden among younger and minority populations highlights the need for targeted, equitable stroke prevention efforts