Key result
In women with prior stroke or TIA, high cardiovascular risk factor scores were associated with increased odds of all-cause ED visits (OR 2.21; 95% CI 1.50-3.25) and hospitalizations (OR 2.18).
Why the study?
The relationship between cardiovascular disease risk factors and health care utilization may differ by sex in individuals with a prior stroke or transient ischemic attack.
Does a higher burden of cardiovascular disease risk factors increase the odds of all-cause ED visits and hospitalizations in women and men with a history of stroke or TIA?
Cross-Sectional (n=9,100,000)
Yes
Does a higher burden of cardiovascular disease risk factors increase the odds of all-cause ED visits and hospitalizations in women and men with a history of stroke or TIA?
A higher burden of cardiovascular risk factors is associated with increased healthcare utilization (ED visits and hospitalizations) in women, but not men, with a history of stroke or TIA.
Background: The relationship between cardiovascular disease risk factors (CVD-RFs) and health care utilization may differ by sex. We determined whether having more CVD-RFs was associated with all-cause emergency department (ED) visits and all-cause hospitalizations for women and men with prior stroke/transient ischemic attack (TIA). Materials and Methods: In this cross-sectional study, we used nationally representative Medical Expenditure Panel Survey (2012–2015) data for persons aged ≥18 years with a prior stroke/TIA. CVD-RF summary scores include six self-reported factors (hypertension, diabetes, high cholesterol, physical inactivity, smoking, and obesity). Sex-specific covariate-adjusted logistic regression models assessed associations between CVD-RF scores and having one or more all-cause ED visits and one or more all-cause hospitalizations. Results: The weighted sample represents 9.1 million individuals (mean age 66.6 years; 54.3% women). Prevalence of low (0–1 risk factors), intermediate (2–3), and high (4–6) CVD-RF scores was 19.4%, 60.5%, and 20.1% for women and 14.6%, 60.2%, and 25.2% for men, respectively. Women having intermediate and high scores had a 1.58-fold (95% confidence interval [CI], 1.14–2.18) and 2.21-fold (95% CI, 1.50–3.25) increased odds of ED visits compared with women with low scores. Women with high CVD-RF scores had a 2.18-fold (95% CI, 1.42–3.34) increased odds of hospitalizations, but there was no association for women with intermediate CVD-RF profiles. There was no association between CVD-RF scores and either outcome for men. Conclusions: Women, but not men, with high and intermediate CVD-RF profiles had increased odds of all-cause ED visits; women with high CVD-RF profiles had increased odds of all-cause hospitalizations. The burden of CVD-RFs may be a sex-specific predictor of higher health care utilization in women with a history of stroke/TIA.
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Chang et al. (2022) conducted a cross-sectional in Prior stroke or transient ischemic attack (TIA) (n=9,100,000). High cardiovascular disease risk factor (CVD-RF) scores vs. Low CVD-RF scores (0-1 risk factors) was evaluated on One or more all-cause emergency department (ED) visits (OR 2.21, 95% CI 1.50-3.25). In women with prior stroke or TIA, high cardiovascular risk factor scores were associated with increased odds of all-cause ED visits (OR 2.21; 95% CI 1.50-3.25) and hospitalizations (OR 2.18).
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