Outcomes of cerebrovascular disease in muscular dystrophies: A propensity-matched nationwide analysis

Abstract

Background and purpose

The literature lacks large studies on outcomes of cerebrovascular disease (CVD) in patients with muscular dystrophies (MDs). Previous studies primarily focused on ischemic stroke. CVD can add considerable morbidity in patients with MD. We aimed to study the outcomes of CVD in patients with MDs using a national database.

Methods

Data were abstracted from the 2010–2021 Nationwide Readmission Database. We identified hospitalizations for CVDs including ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and other unspecified CVDs. We used propensity-score matching to account for selection bias and baseline differences between MD and non-MD patients in type of CVD, age, biological sex, time of discharge, and comorbidity burden. Outcomes were inpatient mortality, 30-day and 90-day readmissions, length of stay, costs and discharge disposition.

Results

There were an estimated 6,129,132 CVD hospitalizations, of which 0.03% (weighted N = 2098) were for patients with MD. Ischemic stroke was the most common type, followed by intracerebral hemorrhage. MD was associated with 41% lower odds of a routine discharge, 9% greater costs, and 30% lower odds of 90-day all-cause readmissions. Inpatient mortality was higher in the MD cohort, but the difference was not statistically significant. There were no significant differences in other outcomes.

Conclusion

The findings of this study provide new insights into the outcomes of CVD in MD patients, highlighting the need for enhanced access to post-discharge care in such patients. Improved post-discharge care may help reduce readmissions and avoid longer hospital stays. This study could be valuable for neurologists, rehabilitation physicians, healthcare administrators and economists.