DOI: 10.1161/str.55.suppl_1.tp172 ISSN: 0039-2499

Abstract TP172: Rising Trends in Cervical Artery Dissection Admissions: A Nationwide Study From 2005 to 2019

Liqi Shu, Austin Jacobson, Han Xiao, Steven Liao, Adam H de Havenon, Thanh N Nguyen, James E Siegler, Setareh Salehi Omran, Eric D Goldstein, Farhan Khan, Hanns Christoph Stretz, Karen L Furie, Shadi Yaghi
  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Neurology (clinical)

Introduction: A recent regional study suggested an upward trend in the incidence rates of spontaneous cervical artery dissection (sCAD). Utilizing a comprehensive nationwide database, we investigated these trends on a national scale.

Method: We analyzed adult patients diagnosed with sCAD in the United States National Inpatient Sample database from 2005 to 2019, employing validated standard ICD-9 and ICD-10 diagnostic codes. By integrating the survey-weighted annual total of CAD cases with annual Census data, we estimated the incidence over the study period. The annualized percentage change (APC) over the study period was estimated using regression models and visually represented with an exponential regression line. Trends were further stratified by sex, age group, and race.

Result: From 2005 to 2019, we identified 557,063,391 patients, of whom 125,102 (0.02%) had non-traumatic CAD. The incidence of CAD increased from 10.5 cases per million population in 2005 to 45.5 cases per million population in 2019 ( P < 0.001), revealing a significant increase in admissions with CAD. Regression analysis estimated an APC of 9.6%, with a 95% CI of 8.4% to 10.7% (P < 0.001) (Figure). This upward trend persisted across all strata of sex, age, and race.

Conclusion: Our nationwide analysis demonstrates a significant rise in admissions with CAD from 2005 to 2019 across all demographic groups. The change in trend could be attributed to greater disease awareness leading to more frequent coding of CAD diagnoses, and/or to increased use of CT angiogram coinciding with the rise of mechanical thrombectomy for stroke. This underscores CAD's increasing clinical prevalence, warranting further investigation into its causes, prevention, and treatment.

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