To assess the length of stay and mortality rate of acute ischemic stroke (AIS) patients diagnosed with Alzheimer’s Disease (AD), and compare with non-Alzheimer’s patients, using data obtained from the National Inpatient Sample (NIS) database from 1998-2017.

AD may increase the risk of ischemic stroke. Previous observational studies reported a greater burden of cerebral small vessel disease and atherosclerosis in patients with AD and AIS. There is increasing evidence for the contribution of Alzheimer’s proteins to ischemic cerebral degeneration. Identifying this particular group of patients will be essential for the prevention of complications.

We used the NIS from the Healthcare Cost and Utilization Project to identify all patients with a primary diagnosis of AIS and AD between 1998 and 2017 using ICD 9 and 10 codes. We implement a multivariate Cox regression analysis to determine hospital outcomes of AD on AIS patients.

We identified 835,380,672 AIS discharges, out of which 25,222,130 had a clinical diagnosis of AD. Two third of discharges were female in the AD group due to female predisposition to AD disease. AIS discharges with AD had a longer length of stay with mean LOS 5.5 ± 5.2 vs. 5.3 ± 6.4 days, [HR=1.06 (1.05,1.07)]. However, this group had lower inpatient mortality during AIS admission [HR=0.93 (0.90,0.97)]. Being older than 75 years of age had the highest in-hospital mortality among all discharges. Overall, Mortality rate [HR=0.55 (0.54,0.57)] and LOS [HR=0.78(0.73,0.83)] of all the ischemic stroke patients improved from 1998 to 2017.

Admissions for AIS amongst patients with AD tended to result in a longer length of stay than non-Alzheimer’s patients. Also, AIS patients with AD had a significantly lower risk of inpatient mortality than non-AD patients.