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Discharge Disposition After Stroke in Patients With Liver Disease.

TitleDischarge Disposition After Stroke in Patients With Liver Disease.
Publication TypeJournal Article
Year of Publication2017
AuthorsParikh NS, Merkler AE, Schneider Y, Navi BB, Kamel H
JournalStroke
Volume48
Issue2
Pagination476-478
Date Published2017 Feb
ISSN1524-4628
KeywordsAdult, Cohort Studies, Female, Hospital Mortality, Humans, Liver Diseases, Male, Patient Discharge, Retrospective Studies, Risk Factors, Stroke
Abstract

BACKGROUND AND PURPOSE: Liver disease is associated with both hemorrhagic and thrombotic processes, including an elevated risk of intracranial hemorrhage. We sought to assess the relationship between liver disease and outcomes after stroke, as measured by discharge disposition.

METHODS: Using administrative claims data, we identified a cohort of patients hospitalized with stroke in California, Florida, and New York from 2005 to 2013. The predictor variable was liver disease. All diagnoses were defined using validated diagnosis codes. Ordinal logistic regression was used to analyze the association between liver disease and worsening discharge disposition: home, nursing/rehabilitation facility, or death. Secondarily, multiple logistic regression was used to analyze the association between liver disease and in-hospital mortality. Models were adjusted for demographics, vascular risk factors, and comorbidities.

RESULTS: We identified 121 428 patients with intracerebral hemorrhage and 703 918 with ischemic stroke. Liver disease was documented in 13 584 patients (1.7%). Liver disease was associated with worse discharge disposition after both intracerebral hemorrhage (global odds ratio, 1.28; 95% confidence interval, 1.19-1.38) and ischemic stroke (odds ratio, 1.23; 95% confidence interval, 1.17-1.29). Similarly, liver disease was associated with in-hospital death after both intracerebral hemorrhage (odds ratio, 1.33; 95% confidence interval, 1.23-1.44) and ischemic stroke (odds ratio, 1.60; 95% confidence interval, 1.51-1.71).

CONCLUSIONS: Liver disease was associated with worse hospital discharge disposition and in-hospital mortality after stroke, suggesting worse functional outcomes.

DOI10.1161/STROKEAHA.116.016016
Alternate JournalStroke
PubMed ID27965428
PubMed Central IDPMC5263024
Grant ListK23 NS082367 / NS / NINDS NIH HHS / United States
K23 NS091395 / NS / NINDS NIH HHS / United States