Patients with recurrent ischemic stroke had two to seven times greater healthcare expenditures compared to those without subsequent strokes, highlighting the economic burden of such events.
Recurrent ischemic stroke following an initial non-cardioembolic stroke or TIA is associated with substantially higher healthcare utilization and costs, highlighting the economic importance of secondary prevention.
Introduction: Following an initial stroke, patients experience a high burden, including more than just inpatient or post-acute-care stays. This study evaluated the real-world clinical and economic burden experienced by patients following a primary IS or TIA of non-cardioembolic origin, stratified by the occurrence of a recurrent IS. Methods: This retrospective cohort study used the Healthcare Integrated Research Database (HIRD ®), a large, nationwide US real-world data source, to identify adults with a non-cardioembolic IS or TIA from Jan 1, 2016 to Jun 30, 2024. Included individuals had a hospitalization or ED visit with an ICD-10-CM diagnosis of IS or TIA (index event) without evidence of prior atrial fibrillation/flutter, left ventricular thrombus, or a mechanical valve, and with at least 1 years’ continuous health plan enrollment prior to and 1 day after the index event. Patients were stratified based on the presence of a recurrent IS over a variable follow-up period. All-cause and stroke-related healthcare utilization and costs are presented as per patient per month (PPPM). Results: The study included 80, 864 individuals with a mean (SD) age of 62. 4 (13. 7) years; 51. 4% were male, 75. 9% were non-Hispanic white, and 5, 715 (7. 1%) had a subsequent IS over a mean (SD) follow-up of 2. 3 (2. 1) years. During the follow-up period, 2, 722 (3. 4%) of the study population had at least one TIA, 4, 674 (5. 8%) had evidence of major bleeding, and 22, 328 (27. 6%) had evidence of disability, defined as inpatient or outpatient rehabilitation or skilled nursing facility visit. Prevalence of these conditions and healthcare encounters, in general, were lower among patients with no subsequent IS (Table 1). Mean (SD) total all-cause healthcare expenditures in 2024 US for the study population were 3, 366 (9, 306) PPPM and total stroke-related healthcare expenditures were 544 (4, 182) PPPM. Inpatient all-cause costs were 1, 393 (7, 754) PPPM and stroke-related inpatient costs were 255 (3, 721) PPPM (Table 2). All-cause and stroke-related costs were two and seven times greater for patients with evidence of subsequent IS compared to those with no evidence of strokes after the index event. Conclusions: Individuals with recurrent IS had considerable disability and utilization of all-cause and stroke-related healthcare services, as well as substantial inpatient costs. Improved secondary stroke prevention may provide an opportunity to increase quality of life and reduce healthcare costs.
Head et al. (2026) studied this question. Patients with recurrent ischemic stroke had two to seven times greater healthcare expenditures compared to those without subsequent strokes, highlighting the economic burden of such events.