Three-month modified Rankin Scale as a determinant of 5-year cumulative costs after ischemic stroke
Seong‐Eun Kim, Heeyoung Lee, Jun Yup Kim, Keon‐Joo Lee, Jihoon Kang, Beom Joon Kim, Moon‐Ku Han, Kang‐Ho Choi, Joon‐Tae Kim, Dong‐Ick Shin, Min-Ju Yeo, Jae‐Kwan Cha, Dae‐Hyun Kim, Hyun‐Wook Nah, Dong‐Eog Kim, Wi‐Sun Ryu, Jong‐Moo Park, Kyusik Kang, Jae Guk Kim, Soo Joo Lee, Mi Sun Oh, Kyung‐Ho Yu, Byung‐Chul Lee, Hong‐Kyun Park, Keun‐Sik Hong, Yong‐Jin Cho, Jay Chol Choi, Sung‐Il Sohn, Jeong‐Ho Hong, Moo‐Seok Park, Tai Hwan Park, Sang‐Soon Park, Kyung Bok Lee, Jee‐Hyun Kwon, Wook‐Joo Kim, Jun Lee, Ji Sung Lee, Juneyoung Lee, Atte Meretoja, Philip B. Gorelick, Hee‐Joon Bae, on behalf of the CRCS-K Investigators
Abstract
<h3>Objective</h3> 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. <h3>Methods</h3> 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. <h3>Results</h3> 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 (US dollars [USD]); the cost in the first year after stroke was the highest ($38,152 USD), which increased markedly from the cost a year before stroke ($8,718 USD). The mean 5-year cumulative costs differed significantly according to the 3-month mRS score (<i>p</i> < 0.001); the costs for a 3-month mRS score of 0 or 5 were $53,578 and $257,486 USD, respectively. Three-month mRS score was an independent determinant of long-term costs after stroke. <h3>Conclusions</h3> 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.