Lingraphica co-founder and chief scientist, Dr. Richard Steele, summarizes the recent findings from a U.S. study on the rate of aphasia among stroke patients discharged from the hospital. Read on for the details.

Researchers from East Carolina University, University of Colorado, and Rush University have collaborated on an analysis of public health records to determine rates of aphasia among stroke patients discharged from U.S. hospitals. Similar analyses from 10 foreign countries, published between 1995 and 2017, revealed rates abroad ranging from 18% in Denmark to 38% in Canada.

The investigators culled data from the Healthcare Cost and Utilization Project, using a convenience sample available from eight US states for the 2011-2012 period. Such records contain longitudinal data collected from all licensed acute care hospitals in the U.S. International Classification of Diseases and Health Related Problems (ICD-9) codes for ischemic stroke, and those for aphasia, were used to identify patients to be counted. To probe for significance between differences in aphasia incidence noted among various racial and ethnic groups, chi-squared tests were employed.

Over the two-year period being studied, a total of 152,972 persons in the eight states were hospitalized for stroke; of these, 28,086—or 18.4%—were discharged with a diagnosis of aphasia. States showed wide variability: North Carolina in 2011 came in lowest at 14.3%, while Colorado in 2012 came in highest at 24.9%. Overall, the rate of aphasia reported among whites (19.3%) was significantly higher than rates among blacks (15.6%) or Hispanics (16.0%). Post-discharge placements are also reported: more than half of the patients with aphasia were discharged to a specialized care facility of some type, such as a skilled nursing facility or an intermediate care facility.

Results indicate that U.S. hospital discharge rates of stroke survivors with aphasia fall into the lower end of the ranges reported internationally. Applying this rate to the annual incidence of stroke across the U.S.—presently estimated at approximately 800,000—the total number of patients being discharged from U.S. hospitals annually with aphasia is estimated at 147,000. Such findings are useful for both clinicians and researchers. The study also suggests a topic of interest for subsequent research. For example, not all persons who experience stroke are admitted to hospitals; and both the accuracy and consistency of ICD-9 coding assignments are influenced by such factors as medical staffs, disease types, and contexts in which diagnoses are made. Follow-on studies that probe impacts of these latter issues may further refine our understandings.

For further reading: C. Ellis, R. Y. Hardy, R. C. Lindrooth, R. K. Peach, 2017. Rate of aphasia among stroke patients discharged from hospitals in the United StatesAphasiology. 

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