-Original-

Incidence Rate and Risk Factors for In-Hospital Ischemic Stroke among 83,990 Hospitalized Patients

Seira Sakurai¹, Kentaro Suzuki¹, Takuya Nishino², Daisuke Hayashi³, Tomonari Saito¹, Yuki Sakamoto¹, Junya Aoki¹, Yasuhiro Nishiyama¹ and Kazumi Kimura¹

¹Department of Neurology, Nippon Medical School, Tokyo, Japan
²Department of Health Care Administration, Nippon Medical School, Tokyo, Japan
³Department of Pharmaceutical Service, Nippon Medical School Hospital, Tokyo, Japan

Background: Details of in-hospital stroke are unknown. This study aimed to clarify the incidence rate and risk factors for in-hospital stroke among all inpatients.
Methods: This retrospective single-center study included consecutive patients admitted to our hospital. Patients aged <18 years, discharged within 24 h, and admitted to the neurology and neurosurgery departments were excluded. The incidence rate for in-hospital stroke was calculated, and patients were divided into stroke and control groups based on ischemic stroke occurrence, and the risk factors were assessed using multivariate analysis.
Results: Of the 83,990 enrolled patients, 101 (0.12%) developed stroke. The stroke group had a higher proportion of patients with older age (76 vs 69 years; P <.01), hypertension (49% vs 26%; P <.01), diabetes mellitus (34% vs 22%; P =.01), atrial fibrillation (25% vs 8%; P <.01), cardiovascular disease (20% vs 11%; P =.01), and emergency admission (68% vs 32%; P <.01) compared to the control group. The risk factors for in-hospital stroke were old age (odds ratio [OR], 1.03; P <.01), hypertension (OR, 1.57; P =.04), diabetes mellitus (OR, 1.61; P =.03), atrial fibrillation (OR, 2.43; P <.01), emergency admission (OR, 3.38; P <.01), and low serum albumin (OR, 0.66; P =.03).
Conclusion: The incidence rate of in-hospital stroke was 0.12% and the independent risk factors were old age, history of hypertension, diabetes mellitus, atrial fibrillation, emergency admission, and low serum albumin.

J Nippon Med Sch 2025; 92: 181-187

Keywords
atrial fibrillation, inpatient, risk factor, stroke

Correspondence to
Kazumi Kimura, Department of Neurology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
k-kimura@nms.ac.jp

Received, December 13, 2024
Accepted, December 26, 2024