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Predict Acute Ischemic Stroke

Identify stroke in patients using computer vision

Problem

Cerebrovascular disease is the fourth leading cause of death among women, the fifth leading cause of death among men, and is a leading cause of serious long-term disability (1). There are nearly 800,000 strokes in the United States each year, and more than 50% of stroke patients are readmitted or die within one year of discharge (2,3). The incidence of stroke increases with age. Approximately 50% occur in people older than 75, and stroke is the second leading cause of hospital admission among the elderly (1,4). Notably, mortality from cerebrovascular disease is increasing significantly among younger adults and has risen by 36% in recent years (1).

Why it matters

  • More than 50% of stroke patients are readmitted or die within one year of discharge (1).
  • Up to 40% of all strokes can be prevented with good blood pressure control (6).
  • 90% of stroke survivors are left with residual functional deficits (2).

The total cost associated with stroke is immense, averaging approximately $50 billion annually (5). Despite recent improvements in acute stroke treatment, more than one-third of patients are functionally dependent or have died within three months of a stroke. Moreover, up to 90% of stroke survivors are left with residual functional deficits that significantly impact quality of life and may increase risk of further adverse outcomes (2). For example, immobility limits cardiovascular exercise and increases the risk for recurrent stroke and cardiovascular illness. Nearly one in four strokes occur in people who have previously had a stroke (5).

Solution

Preventive interventions that account for modifiable risk factors can potentially reduce the incidence of stroke in high-risk patients. To this end, predictive analytics are critical for proactively and accurately identifying such patients and helping to facilitate proven interventions on an individual level. Interventions that address hypertension—a risk factor for 90% of all strokes—have proven to be effective, and it is estimated that up to 40% of all strokes can be prevented with good blood pressure control (6). Similarly, self-management interventions can significantly reduce risk. Smoking is associated with up to four times increased risk of stroke, and frequent exercise can reduce risk by up to half (6). For patients who have had a stroke, multidisciplinary rehabilitation programs remain the mainstay of treatment to improve outcomes and prevent secondary strokes (2).

Datasources

  • Electronic Health Records: EHR data with comprehensive patient histories of vital signs and symptoms, problem lists and chief complaints, tests results, diagnoses and procedures, and prescriptions.
  • EHR Problem Lists: Data capturing the most important problems facing a patient, when it occurred and when it was resolved, and lists other illnesses, injuries and factors that affect their health.
  • Medical Claims: Data extracted from health insurance medical claims with details about dates and place of service, diagnosis codes, key procedures, use of medical equipment, and provider specialties.

Citations

  1. Tong, Xin, et al. “The Burden of Cerebrovascular Disease in the United States.” Preventing Chronic Disease, vol. 16, 25 Apr. 2019, 10.5888/pcd16.180411.
  2. Winstein, Carolee J., et al. “Guidelines for Adult Stroke Rehabilitation and Recovery. Stroke, vol. 47, no. 6, June 2016, 10.1161/str.0000000000000098.
  3. Bates, Barbara E., et al. “One-Year All-Cause Mortality After Stroke: A Prediction Model.” PMBR, vol. 6, no. 6, 7 Nov. 2013, pp. 473-483, pubmed.ncbi.nlm.nih.gov/24211696/, 10.1016/j.pmrj.2013.1.006.
  4. Bravata, Dawn M., et al. “Readmission and Death After Hospitalization for Acute Ischemic Stroke.” Stroke, vol. 38, no. 6, June 2007, pp. 1899-1904, 10.1161/strokeaha.106.481465.
  5. Virani, Salim S., et al. “Heart Disease and Stroke Statistics 2020 Update: A Report from the American Heart Association.” Circulation, vol. 141, no. 9, 3 Mar. 2020, pp. 139-596, doi/10.1161/CIR.0000000000000757.
  6. Ayan Sabih, et al. “Stroke Prevention” National Center for Biotechnology Information, StatPearls Publishing, 8 July 2020. Accessed 19 Feb. 2021.

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