Trends in cancer diagnoses among inpatients hospitalized with stroke

Abstract

Background: Cancer, by conferring a hypercoagulable state, may lead to an ischemic stroke. Relatively little is known about the prevalence and evolution of cancer among stroke patients over the last decade.

Methods: We used the Nationwide Inpatient Sample to identify discharges with any InternationalClassification of Diseases, Ninth Revision, diagnosis code for cancer and ischemic stroke from 1997 to 2006. We then calculated age-adjusted yearly acute ischemic stroke hospitalization rates among adult populations with and without cancer.

Results: Prevalence of cancer among hospitalized stroke patients increased from 1997 to 2006 (N = 31,075 [9.1% of all ischemic stroke hospitalizations] to 34,138 [10.6%], P < .0001). The most common types of cancer among hospitalized stroke patients in 1997 and 2006 were prostate (21% versus 19%), breast (19% versus 19%), gastrointestinal (16% versus 13%), and colorectal (13% versus 13%). Over the decade there was a significant decrease in the prevalence of stroke hospitalizations (slope -3.02, 95% confidence interval -3.69 to -2.34), but not among cancer patients (slope 1.35, 95% confidence interval -0.88 to 3.58).

Conclusion: About 1 in 10 hospitalized ischemic stroke patients in the United States has comorbid cancer, and there has been a slight rise in this rate over the last decade. This is likely due to enhanced survival from better cancer treatments, but further study is warranted.

Keywords: Cancer; prevalence; stroke; trends.