Relationship Between Cerebrovascular Diseases and Vasculitis: A Cross-Sectional Nationwide Inpatient Study

Anusheel; Johanna S Canenguez Benitez; Sanobar Jaka; Nikhita S Roshan; Sravani Kommuru; Samreen Ahmed; Gagan Kaur; Ninad Desai

doi:10.7759/cureus.27435

Relationship Between Cerebrovascular Diseases and Vasculitis: A Cross-Sectional Nationwide Inpatient Study

Cureus. 2022 Jul 29;14(7):e27435. doi: 10.7759/cureus.27435. eCollection 2022 Jul.

Authors

Anusheel¹, Johanna S Canenguez Benitez², Sanobar Jaka³, Nikhita S Roshan⁴, Sravani Kommuru⁵, Samreen Ahmed⁶, Gagan Kaur⁷, Ninad Desai⁸

Affiliations

¹ Medicine, Shanti Gopal Hospital, Ghaziabad, IND.
² Internal Medicine, Larkin Community Hospital, South Miami, USA.
³ Epidemiology and Public Health, Psychiatry, New York University (NYU) School of Global Public Health, New York, USA.
⁴ Neurology, Father Muller Medical College, Mangalore, IND.
⁵ Internal Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, IND.
⁶ Neurology, University of Illinois, Chicago, USA.
⁷ Medicine, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, IND.
⁸ Neurology, St. Vincent's Medical Center, Bridgeport, USA.

Abstract

Objectives To evaluate the risk factors and hospitalization outcomes for cerebrovascular diseases (CVD) in patients with vasculitis. Methods We conducted a cross-sectional study using the Nationwide Inpatient Sample (NIS), 2019. We included 26,855 adults (aged 18 to 65 years, average age 48.57 ± 12.79 years) with a co-diagnosis of vasculitis, and the sample was divided by the primary diagnosis of CVD (N = 670, 2.5%). A demographic-adjusted logistic regression model was used to evaluate the odds ratio (OR) of association with CVD in patients with vasculitis by comparing it to the non-CVD cohort. Results The majority of the vasculitis patients with CVD were elders (51 to 65 years, 46%), females (62%), and whites (52%). There was a significant difference in the geographic distribution of CVD with vasculitis with the highest prevalence in the South Atlantic (23%) and Middle Atlantic (16%), and the lowest in the Mountain (4%) and New England (2%). Vasculitis patients with comorbid lymphoma (OR 2.46, P<0.001), peripheral vascular diseases (PVD (OR 1.54, P<0.001)), and complicated hypertension (OR 1.31, P<0.001) were associated with increasing the likelihood for CVD-related hospitalization. The mean length of stay was 13 days and the mean cost was $169,440 per CVD-related hospitalization in vasculitis patients. Cerebrovascular diseases in patients with vasculitis resulted in a major loss of body functioning (80%) leading to adverse disposition including transfer to a skilled nursing facility/intermediate care facility (22%) and requiring home health care (13%). Conclusion The prevalence of CVD-related hospitalization in vasculitis patients was 2.5% and females were observed to be at higher risk. Comorbid lymphoma, PVD, and hypertension further increase the risk for CVD with vasculitis. They have a higher loss of functioning that affects patient quality of life and require increased care after hospital discharge.

Keywords: cerebral vasculitis; cerebro-vascular accident (stroke); hospitalization outcomes; hypertension; risk factors.