Three-month modified Rankin Scale as a determinant of 5-year cumulative costs after ischemic stroke: An analysis of 11,136 patients in Korea

초록

Objective Stroke is a devastating and costly disease; however, there is a paucity of information on long-term costs and on how they differ according to 3-month modified Rankin scale (mRS) score, which is a primary outcome variable in acute stroke intervention trials. Methods We analyzed a prospective multicenter stroke registry (Clinical Research Collaboration for Stroke in Korea) database through linkage with claims data from the National Health Insurance Service with follow-up to December 2016. Healthcare expenditures were converted into daily cost individually, and annual and cumulative costs up to 5 years were estimated and compared according to the 3-month mRS score. Results Between January 2011 and November 2013, 11,136 patients were enrolled in the study. The mean age was 68 years, and 58% were men. The median follow-up period was 3.9 years (range 0–5 years). Mean cumulative cost over 5 years was $117,576(USdollars[USD]);thecostinthefirstyearafterstrokewasthehighest($38,152 USD), which increased markedly from the cost a year before stroke ($8,718USD).Themean5-yearcumulativecostsdifferedsignificantlyaccordingtothe3-monthmRSscore(p<0.001);thecostsfora3-monthmRSscoreof0or5were$53,578 and $257,486 USD, respectively. Three-month mRS score was an independent determinant of long-term costs after stroke. Conclusions We show that 3-month mRS score plays an important role in the prediction of long-term costs after stroke. Such estimates relating to 3-month mRS categories may be valuable when undertaking health economic evaluations related to stroke care.

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