Mohammed Mustapha, Zainal Hadzliana, Ong Siew Chin, Tangiisuran Balamurugan, Aziz Fatimatuzzahra Abdul, Sha'aban Abubakar, Abubakar Usman, Sidek Norsima Nazifah, Looi Irene, Aziz Zariah A
Biomedical Research Center, QU Health, Qatar University, Doha, Qatar.
School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia.
Sci Rep. 2025 Jul 2;15(1):22571. doi: 10.1038/s41598-025-07026-1.
Understanding the economic impact of first-ever stroke in a multiethnic population like Malaysia is essential for informed resource allocation. This study aimed to evaluate the direct medical costs associated with first-ever ischemic stroke in Malaysia. The study was a retrospective cohort study that estimated the inpatient direct medical costs of first-ever ischemic stroke in Malaysia. The study involved 122 adult patients managed at Hospital Sultanah Nur Zahirah, Terengganu (HSNZ), enrolled in the Malaysian National Stroke Registry (NSR) from 2009 to 2020. The mean ± standard deviation (SD) for the patients' age was 61.0 ± 10.9 years, the length of stay (LOS) was 4.5 ± 3.5 days, and the modified Rankin scale (mRS) score was 3.0 ± 1.1. Most patients experienced functional disability (poor functional status, mRS ≥ 3) and incurred an average (SD) treatment cost of MYR 1,970.7 ± 1,385.8, primarily attributed to hospital admissions and radiology expenses. The medical costs were significantly lower in patients with good functional status [mRS < 3 (p = 0.002)] and shorter LOS (p < 0.001), but higher in patients with the partial anterior circulation infarct (PACI) stroke subtype (p < 0.001). Additionally, patients with good functional status incurred significantly lower costs for admission and medications (p < 0.001). In conclusion, the inpatient direct medical cost of first-ever ischemic stroke in Malaysia is substantial and is influenced by stroke subtypes, length of stay, risk factors, and functional status. Strategies to reduce the length of stay, comorbidities, and functional status can potentially reduce the economic burden of the first-ever acute ischemic stroke. These findings are crucial for guiding the optimal allocation of resources for stroke care.
了解像马来西亚这样的多民族人群中首次中风的经济影响对于明智地分配资源至关重要。本研究旨在评估马来西亚首次缺血性中风的直接医疗费用。该研究是一项回顾性队列研究，估算了马来西亚首次缺血性中风的住院直接医疗费用。该研究纳入了2009年至2020年在登嘉楼苏丹娜努尔扎希拉医院（HSNZ）接受治疗并被纳入马来西亚国家中风登记册（NSR）的122名成年患者。患者的平均年龄±标准差（SD）为61.0±10.9岁，住院时间（LOS）为4.5±3.5天，改良Rankin量表（mRS）评分为3.0±1.1。大多数患者存在功能残疾（功能状态差，mRS≥3），平均（SD）治疗费用为1970.7±1385.8马来西亚林吉特，主要归因于住院和放射学费用。功能状态良好的患者[mRS<3（p=0.002）]和住院时间较短的患者（p<0.001）医疗费用显著较低，但部分前循环梗死（PACI）中风亚型的患者医疗费用较高（p<0.001）。此外，功能状态良好的患者住院和用药费用显著较低（p<0.001）。总之，马来西亚首次缺血性中风的住院直接医疗费用很高，且受中风亚型、住院时间、危险因素和功能状态的影响。缩短住院时间、减少合并症和改善功能状态的策略可能会减轻首次急性缺血性中风的经济负担。这些发现对于指导中风护理资源的优化分配至关重要。
