Trends in hospitalizations and epidemiological characteristics of adults Moyamoya disorder in the United States
There has been an increasing prevalence of Moyamoya disorder (MMD) reported from recent US literature. There is a paucity of data available regarding trends of prevalence and epidemiological factors in the United States. To goal of this study was to test the hypotheses that racial-, sex-specific MMD...
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| creator | Patel, Smit D. Desai, Ninad Rane, Schweta Patel, Neel Desai, Rupak Mehta, Tapan Ollenschleger, Martin D. Nanda, Anil Starke, Robert M. Khandelwal, Priyank |
| description | There has been an increasing prevalence of Moyamoya disorder (MMD) reported from recent US literature. There is a paucity of data available regarding trends of prevalence and epidemiological factors in the United States. To goal of this study was to test the hypotheses that racial-, sex-specific MMD hospitalizations and epidemiological factors have been increasing in the United States over the last decade.
In this retrospective observational study, using the National Inpatient Sample (NIS) database from 2005 to 2016, MMD-related hospitalizations in patients aged ≥18 years were identified. Trends of epidemiological factors were analyzed over time using the linear regression model with the significance of differences in trend over time assessed using the Wald test. Sex- and race-specific burden of MMD were calculated using the annual US Census data. Joinpoint regression model was used to evaluate trends of hospitalizations over time.
A total of 24,484 adult hospitalizations were identified from January 2005 to September 2015 after excluding |
| doi_str_mv | 10.1016/j.jns.2020.117165 |
| format | Article |
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In this retrospective observational study, using the National Inpatient Sample (NIS) database from 2005 to 2016, MMD-related hospitalizations in patients aged ≥18 years were identified. Trends of epidemiological factors were analyzed over time using the linear regression model with the significance of differences in trend over time assessed using the Wald test. Sex- and race-specific burden of MMD were calculated using the annual US Census data. Joinpoint regression model was used to evaluate trends of hospitalizations over time.
A total of 24,484 adult hospitalizations were identified from January 2005 to September 2015 after excluding <18 years. Among them, approximately ~90% were aged ≤60 years, and 73.5% were females. The most common vascular and non-vascular presentations were ischemic stroke (17.3%) and seizures (21%), respectively. The trend of antithrombotic therapy has increased, while extracranial-intracranial bypass has remained stagnant. The actual average hospitalizations of MMD was 10.4 cases/ million population/year (range 4.1–17.9) and varied significantly by sex (females 14.7 [range 6.2–23.6] and males 5.9 [range 1.8–11.9]) over the 2005 to 2016 study period. The burden of hospitalizations also differed by race (African Americans 40.6 [range 32.8–63.7], Asians 24.8 [15.4–34.8], Non-Hispanic Whites 8.1 [range 6.4–11.5], and Hispanics 8.4 [2.8–12.8]) over the 2010 to 2016 study period. Joinpoint regression analysis showed an increasing overall MMD trend across the study period (+11.7%; P < 0.001), which was higher in males (+14.5% vs. +10.7%; P < 0.001). The Hispanic group had significantly increased hospitalizations over the years (+20.2%; P < 0.001).
Although overall more prevalent in females, MMD-related hospitalizations are increasing more rapidly in males. Among the racial subpopulations, African Americans had the highest MMD-related hospitalizations, even higher than Asian Americans. MMD-related hospitalizations have increased quicker in Hispanics than in any other racial group.
•Moyamoya disorder (MMD) is an increasingly recognized cause for stroke in the US. reka•African Americans have the highest MMD-related hospitalization rate among all racial groups.•Although overall higher in females, the rate of MMD-related hospitalizations are rising faster in males.•MMD presents more often as ischemic rather than hemorrhagic stroke in the Western population.•The use of antithrombotics has increased over the years; EC-IC bypass procedure performance rates have remained static.</description><identifier>ISSN: 0022-510X</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/j.jns.2020.117165</identifier><identifier>PMID: 33059298</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Adolescent ; Adult ; Aged ; EC-IC bypass ; European Continental Ancestry Group ; Female ; Hemorrhagic stroke ; Hospitalization ; Humans ; Ischemic stroke ; Male ; Moyamoya disease ; Moyamoya Disease - epidemiology ; Moyamoya Disease - therapy ; Moyamoya vasculopathy ; Retrospective Studies ; Sickle cell disease ; Stroke ; Subarachnoid hemorrhage ; United States - epidemiology</subject><ispartof>Journal of the neurological sciences, 2020-12, Vol.419, p.117165-117165, Article 117165</ispartof><rights>2020 Elsevier B.V.</rights><rights>Copyright © 2020 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-555d993cf122f37a57bb2bc0de8b92745823f68421c1c2cc6dce7e85f5da66423</citedby><cites>FETCH-LOGICAL-c353t-555d993cf122f37a57bb2bc0de8b92745823f68421c1c2cc6dce7e85f5da66423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jns.2020.117165$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33059298$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Patel, Smit D.</creatorcontrib><creatorcontrib>Desai, Ninad</creatorcontrib><creatorcontrib>Rane, Schweta</creatorcontrib><creatorcontrib>Patel, Neel</creatorcontrib><creatorcontrib>Desai, Rupak</creatorcontrib><creatorcontrib>Mehta, Tapan</creatorcontrib><creatorcontrib>Ollenschleger, Martin D.</creatorcontrib><creatorcontrib>Nanda, Anil</creatorcontrib><creatorcontrib>Starke, Robert M.</creatorcontrib><creatorcontrib>Khandelwal, Priyank</creatorcontrib><title>Trends in hospitalizations and epidemiological characteristics of adults Moyamoya disorder in the United States</title><title>Journal of the neurological sciences</title><addtitle>J Neurol Sci</addtitle><description>There has been an increasing prevalence of Moyamoya disorder (MMD) reported from recent US literature. There is a paucity of data available regarding trends of prevalence and epidemiological factors in the United States. To goal of this study was to test the hypotheses that racial-, sex-specific MMD hospitalizations and epidemiological factors have been increasing in the United States over the last decade.
In this retrospective observational study, using the National Inpatient Sample (NIS) database from 2005 to 2016, MMD-related hospitalizations in patients aged ≥18 years were identified. Trends of epidemiological factors were analyzed over time using the linear regression model with the significance of differences in trend over time assessed using the Wald test. Sex- and race-specific burden of MMD were calculated using the annual US Census data. Joinpoint regression model was used to evaluate trends of hospitalizations over time.
A total of 24,484 adult hospitalizations were identified from January 2005 to September 2015 after excluding <18 years. Among them, approximately ~90% were aged ≤60 years, and 73.5% were females. The most common vascular and non-vascular presentations were ischemic stroke (17.3%) and seizures (21%), respectively. The trend of antithrombotic therapy has increased, while extracranial-intracranial bypass has remained stagnant. The actual average hospitalizations of MMD was 10.4 cases/ million population/year (range 4.1–17.9) and varied significantly by sex (females 14.7 [range 6.2–23.6] and males 5.9 [range 1.8–11.9]) over the 2005 to 2016 study period. The burden of hospitalizations also differed by race (African Americans 40.6 [range 32.8–63.7], Asians 24.8 [15.4–34.8], Non-Hispanic Whites 8.1 [range 6.4–11.5], and Hispanics 8.4 [2.8–12.8]) over the 2010 to 2016 study period. Joinpoint regression analysis showed an increasing overall MMD trend across the study period (+11.7%; P < 0.001), which was higher in males (+14.5% vs. +10.7%; P < 0.001). The Hispanic group had significantly increased hospitalizations over the years (+20.2%; P < 0.001).
Although overall more prevalent in females, MMD-related hospitalizations are increasing more rapidly in males. Among the racial subpopulations, African Americans had the highest MMD-related hospitalizations, even higher than Asian Americans. MMD-related hospitalizations have increased quicker in Hispanics than in any other racial group.
•Moyamoya disorder (MMD) is an increasingly recognized cause for stroke in the US. reka•African Americans have the highest MMD-related hospitalization rate among all racial groups.•Although overall higher in females, the rate of MMD-related hospitalizations are rising faster in males.•MMD presents more often as ischemic rather than hemorrhagic stroke in the Western population.•The use of antithrombotics has increased over the years; EC-IC bypass procedure performance rates have remained static.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>EC-IC bypass</subject><subject>European Continental Ancestry Group</subject><subject>Female</subject><subject>Hemorrhagic stroke</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Ischemic stroke</subject><subject>Male</subject><subject>Moyamoya disease</subject><subject>Moyamoya Disease - epidemiology</subject><subject>Moyamoya Disease - therapy</subject><subject>Moyamoya vasculopathy</subject><subject>Retrospective Studies</subject><subject>Sickle cell disease</subject><subject>Stroke</subject><subject>Subarachnoid hemorrhage</subject><subject>United States - epidemiology</subject><issn>0022-510X</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1r3DAQhkVpaTZpf0AuRcdevNHHypbpqYS2CSTk0ARyE7I0zs5iWxuNNpD--njZpMcchmHgeV-Yh7FTKZZSyPpss9xMtFRCzbdsZG0-sIW0ja2MtfojWwihVGWkuD9ix0QbIURtbfuZHWktTKtau2DpNsMUiePE14m2WPyA_3zBNBH3U-SwxQgjpiE9YPADD2uffSiQkQoG4qnnPu6GQvw6PftxHh6RUo6Q951lDfxuwgKR_y2-AH1hn3o_EHx93Sfs7vev2_OL6urmz-X5z6sqaKNLZYyJbatDL5XqdeNN03WqCyKC7VrVrIxVuq_tSskggwqhjgEasKY30df1SukT9v3Qu83pcQdU3IgUYBj8BGlHTq2MtEbWWsyoPKAhJ6IMvdtmHH1-dlK4vWe3cbNnt_fsDp7nzLfX-l03QvyfeBM7Az8OAMxPPiFkRwFhChAxQyguJnyn_gXVLY_0</recordid><startdate>20201215</startdate><enddate>20201215</enddate><creator>Patel, Smit D.</creator><creator>Desai, Ninad</creator><creator>Rane, Schweta</creator><creator>Patel, Neel</creator><creator>Desai, Rupak</creator><creator>Mehta, Tapan</creator><creator>Ollenschleger, Martin D.</creator><creator>Nanda, Anil</creator><creator>Starke, Robert M.</creator><creator>Khandelwal, Priyank</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20201215</creationdate><title>Trends in hospitalizations and epidemiological characteristics of adults Moyamoya disorder in the United States</title><author>Patel, Smit D. ; Desai, Ninad ; Rane, Schweta ; Patel, Neel ; Desai, Rupak ; Mehta, Tapan ; Ollenschleger, Martin D. ; Nanda, Anil ; Starke, Robert M. ; Khandelwal, Priyank</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c353t-555d993cf122f37a57bb2bc0de8b92745823f68421c1c2cc6dce7e85f5da66423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>EC-IC bypass</topic><topic>European Continental Ancestry Group</topic><topic>Female</topic><topic>Hemorrhagic stroke</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Ischemic stroke</topic><topic>Male</topic><topic>Moyamoya disease</topic><topic>Moyamoya Disease - epidemiology</topic><topic>Moyamoya Disease - therapy</topic><topic>Moyamoya vasculopathy</topic><topic>Retrospective Studies</topic><topic>Sickle cell disease</topic><topic>Stroke</topic><topic>Subarachnoid hemorrhage</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Patel, Smit D.</creatorcontrib><creatorcontrib>Desai, Ninad</creatorcontrib><creatorcontrib>Rane, Schweta</creatorcontrib><creatorcontrib>Patel, Neel</creatorcontrib><creatorcontrib>Desai, Rupak</creatorcontrib><creatorcontrib>Mehta, Tapan</creatorcontrib><creatorcontrib>Ollenschleger, Martin D.</creatorcontrib><creatorcontrib>Nanda, Anil</creatorcontrib><creatorcontrib>Starke, Robert M.</creatorcontrib><creatorcontrib>Khandelwal, Priyank</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Patel, Smit D.</au><au>Desai, Ninad</au><au>Rane, Schweta</au><au>Patel, Neel</au><au>Desai, Rupak</au><au>Mehta, Tapan</au><au>Ollenschleger, Martin D.</au><au>Nanda, Anil</au><au>Starke, Robert M.</au><au>Khandelwal, Priyank</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends in hospitalizations and epidemiological characteristics of adults Moyamoya disorder in the United States</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2020-12-15</date><risdate>2020</risdate><volume>419</volume><spage>117165</spage><epage>117165</epage><pages>117165-117165</pages><artnum>117165</artnum><issn>0022-510X</issn><eissn>1878-5883</eissn><abstract>There has been an increasing prevalence of Moyamoya disorder (MMD) reported from recent US literature. There is a paucity of data available regarding trends of prevalence and epidemiological factors in the United States. To goal of this study was to test the hypotheses that racial-, sex-specific MMD hospitalizations and epidemiological factors have been increasing in the United States over the last decade.
In this retrospective observational study, using the National Inpatient Sample (NIS) database from 2005 to 2016, MMD-related hospitalizations in patients aged ≥18 years were identified. Trends of epidemiological factors were analyzed over time using the linear regression model with the significance of differences in trend over time assessed using the Wald test. Sex- and race-specific burden of MMD were calculated using the annual US Census data. Joinpoint regression model was used to evaluate trends of hospitalizations over time.
A total of 24,484 adult hospitalizations were identified from January 2005 to September 2015 after excluding <18 years. Among them, approximately ~90% were aged ≤60 years, and 73.5% were females. The most common vascular and non-vascular presentations were ischemic stroke (17.3%) and seizures (21%), respectively. The trend of antithrombotic therapy has increased, while extracranial-intracranial bypass has remained stagnant. The actual average hospitalizations of MMD was 10.4 cases/ million population/year (range 4.1–17.9) and varied significantly by sex (females 14.7 [range 6.2–23.6] and males 5.9 [range 1.8–11.9]) over the 2005 to 2016 study period. The burden of hospitalizations also differed by race (African Americans 40.6 [range 32.8–63.7], Asians 24.8 [15.4–34.8], Non-Hispanic Whites 8.1 [range 6.4–11.5], and Hispanics 8.4 [2.8–12.8]) over the 2010 to 2016 study period. Joinpoint regression analysis showed an increasing overall MMD trend across the study period (+11.7%; P < 0.001), which was higher in males (+14.5% vs. +10.7%; P < 0.001). The Hispanic group had significantly increased hospitalizations over the years (+20.2%; P < 0.001).
Although overall more prevalent in females, MMD-related hospitalizations are increasing more rapidly in males. Among the racial subpopulations, African Americans had the highest MMD-related hospitalizations, even higher than Asian Americans. MMD-related hospitalizations have increased quicker in Hispanics than in any other racial group.
•Moyamoya disorder (MMD) is an increasingly recognized cause for stroke in the US. reka•African Americans have the highest MMD-related hospitalization rate among all racial groups.•Although overall higher in females, the rate of MMD-related hospitalizations are rising faster in males.•MMD presents more often as ischemic rather than hemorrhagic stroke in the Western population.•The use of antithrombotics has increased over the years; EC-IC bypass procedure performance rates have remained static.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>33059298</pmid><doi>10.1016/j.jns.2020.117165</doi><tpages>1</tpages></addata></record> |
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| subjects | Adolescent Adult Aged EC-IC bypass European Continental Ancestry Group Female Hemorrhagic stroke Hospitalization Humans Ischemic stroke Male Moyamoya disease Moyamoya Disease - epidemiology Moyamoya Disease - therapy Moyamoya vasculopathy Retrospective Studies Sickle cell disease Stroke Subarachnoid hemorrhage United States - epidemiology |
| title | Trends in hospitalizations and epidemiological characteristics of adults Moyamoya disorder in the United States |
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