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Cardiovascular-Related Hospitalization among Michigan Adults - 2017

Major Cardiovascular Disease Listed as Primary Diagnosis per 100,000 Michigan Adults (18 Years and Older)

 Characteristics  Hospital Discharges per 100,000 Michigan Adults  95% CI 
   Michigan (Rate Unadjusted)  2,181.9  (2,171.7-2,192.2) 
   Michigan (Rate Age-Adjusted)  1,821.0  (1,812.3- 1,829.7) 
     
 Characteristics (Rate Unadjusted)    
 Age Group (Years)    
  18-44  256.9  (251.5-262.3) 
   45-64  1,837.9  (1,822.0-1,853.9) 
   65 and Older  6,664.5  (6,626.7-6,702.4) 
     
 Gender    
   Male  2,419.1  (2,403.7-2,434.6)
   Female  1,956.7   (1,943.2-1,970.3) 
     
 Race    
   Non-Hispanic White  2,206.6  (2,194.9-2,218.3) 
   Non-Hispanic Black  3,024.1  (2,991.5-3,056.7)

95% CI = 95% Confidence Interval

The following ICD-10 CM diagnosis codes were used to define major cardiovascular disease (major CVD): Diseases of the heart (I00-I09, I11, I13, I20-I51); Cerebrovascular disease (I60-I69); and Diseases of the arteries, arterioles and capillaries (I70-I78).

 


 

Length of Stay - Major Cardiovascular Disease Listed as Primary Diagnosis

 Length of Stay  Days  Standard Deviation
   Average Length of Stay  5.2  ±5.0
   Median Length of Stay  4  
   Most Frequent Length of Stay  2  

Standard deviation applies only to average

The following ICD-10 CM diagnosis codes were used to define major cardiovascular disease (major CVD): Diseases of the heart (I00-I09, I11, I13, I20-I51); Cerebrovascular disease (I60-I69); and Diseases of the arteries, arterioles and capillaries (I70-I78).

 


 

Heart Attack Listed as Primary Diagnosis per 100,000 Michigan Adults (18 Years and Older)

 Characteristics  Hospital Discharges per 100,000 Michigan Adults  95% CI
   Michigan (Rate Unadjusted)  325.9  (321.9-329.9)
   Michigan (Rate Age-Adjusted)  272.8  (269.4- 276.1)
     
 Characteristics (Rate Unadjusted)    
 Age Group (Years)    
   18-44  35.9  (33.9-37.9)
   45-64  332.4  (325.6-339.3)
   65 and Older  906.0  (891.6-920.4)
     
 Gender    
   Male  396.5  (390.2-402.8)
   Female  258.9  (253.9-263.9)
     
 Race    
   Non-Hispanic White  343.3  (338.7-348.0)
   Non-Hispanic Black  368.9  (357.4-380.4)

95% CI = 95% Confidence Interval

The following ICD-10 CM diagnosis codes were used to define heart attack: ICD-10 CM diagnosis codes I21 and I22

 


 

Length of Stay - Heart Failure Listed as Primary Diagnosis

 Length of Stay  Days  Standard Deviation
   Average Length of Stay  5.5  ±7.3
   Median Length of Stay  4  
   Most Frequent Length of Stay  2  

Standard deviation applies only to average

The following ICD-10 CM diagnosis code was used to define heart failure: ICD-10 CM diagnosis code I50

 


 

Coronary Heart Disease Listed as Primary Diagnosis per 100,000 Michigan Adults (18 Years and Older)

 Characteristics  Hospital Discharges per 100,000 Michigan Adults  95% CI
   Michigan (Rate Unadjusted)  513.4  (508.4-518.4)
   Michigan (Rate Age-Adjusted)  429.1  (424.9- 433.4)
     
 Characteristics (Rate Unadjusted)    
 Age Group (Years)    
   18-44  51.5  (49.1-54.0)
   45-64  542.4  (533.7-551.1)
   65 and Older  1,406.7  (1,388.9-1,424.6)
     
 Gender    
   Male  647.2  (639.1-655.3)
   Female  386.4  (380.3-392.5)
     
 Race    
   Non-Hispanic White  539.6  (533.7-545.4)
   Non-Hispanic Black  580.3  (565.9-594.7)
     

95% CI = 95% Confidence Interval

The following ICD-10 CM diagnosis codes were used to define coronary heart disease: ICD-10 CM diagnosis codes I20-I25

 


 

Length of Stay - Coronary Heart Disease Listed as Primary Diagnosis

Length of Stay  Days  Standard Deviation
  Average Length of Stay  4.6  ±4.8
  Median Length of Stay  4
  Most Frequent Length of Stay  2

Standard deviation applies only to average

The following ICD-10 CM diagnosis codes were used to define coronary heart disease: ICD-10 CM diagnosis codes I20-I25

 


 

Transient Ischemic Attack (TIA) Listed as Primary Diagnosis per 100,000 Michigan Adults (18 Years and Older)

 Characteristics  Hospital Discharges per 100,000 Michigan Adults  95% CI
   Michigan (Rate Unadjusted)  61.1   (59.4-62.8)
   Michigan (Rate Age-Adjusted)  50.6   (49.2- 52.1)
     
 Characteristics (Rate Unadjusted)    
 Age Group (Years)    
   18-44  6.0  (5.2-6.8)
   45-64  44.6  (42.0-47.1) 
   65 and Older  200.3  (193.5-207.1)
     
 Gender    
   Male  53.9  (51.6-56.3)
   Female  67.9  (65.3-70.4)
     
 Race    
   Non-Hispanic White  60.2  (58.3-62.2)
   Non-Hispanic Black  93.5  (87.7-99.4)

95% CI = 95% Confidence Interval

The following ICD-10 CM diagnosis code was used to define TIA: ICD-10 CM diagnosis code G45

 


 

Length of Stay - Transient Ischemic Attack (TIA) Listed as Primary Diagnosis

Length of Stay  Days  Standard Deviation
  Average Length of Stay  2.6  ±5.6
  Median Length of Stay  2
  Most Frequent Length of Stay  2

Standard deviation applies only to average

The following ICD-10 CM diagnosis code was used to define TIA: ICD-10 CM diagnosis code G45

 


 

Stroke (Ischemic and Hemorrhagic Combined) Listed as Primary Diagnosis per 100,000 Michigan Adults (18 Years and Older)

 Characteristics  Hospital Discharges per 100,000 Michigan Adults  95% CI
   Michigan (Rate Unadjusted)  413.7  (409.2-418.3)
   Michigan (Rate Age-Adjusted)  344.3  (340.6- 348.1)
     
 Characteristics (Rate Unadjusted)    
 Age Group (Years)    
   18-44  43.3  (41.1-45.5)
   45-64  350.1  (343.0-357.1)
   65 and Older  1,272.3  (1,255.3-1,289.3)
     
 Gender    
   Male  423.5  (417.0-430.1)
   Female  404.5  (398.2-410.7)
     
 Race    
   Non-Hispanic White  411.0  (405.9-416.1)
   Non-Hispanic Black  606.3  (591.5-621.0)

95% CI = 95% Confidence Interval

The following ICD-10 CM diagnosis codes were used to define stroke: ICD-10 CM diagnosis codes I60-I69

 


 

Length of Stay - Stroke (Ischemic and Hemorrhagic Combined) Listed as Primary Diagnosis

Length of Stay  Days  Standard Deviation
  Average Length of Stay  6.3  ±7.0
  Median Length of Stay  4
  Most Frequent Length of Stay  1

Standard deviation applies only to average

The following ICD-10 CM diagnosis codes were used to define stroke: ICD-10 CM diagnosis codes I60-I69

 


 

Ischemic Stroke Listed as Primary Diagnosis per 100,000 Michigan Adults (18 Years and Older)

 Characteristics  Hospital Discharges per 100,000 Michigan Adults  95% CI
   Michigan (Rate Unadjusted)  275.3  (271.7-279.0)
   Michigan (Rate Age-Adjusted)  227.8  (224.7- 230.9)
     
 Characteristics (Rate Unadjusted)    
 Age Group (Years)    
   18-44  22.9  (21.3-24.5)
   45-64  221.2  (215.6-226.8) 
   65 and Older  877.9  (863.8-892.1)
     
 Gender    
   Male  286.7  (281.3-292.1)
   Female  264.5  (259.5-269.6)
     
 Race    
   Non-Hispanic White  280.8  (276.6-285.0)
   Non-Hispanic Black  365.7  (354.2-377.2)

95% CI = 95% Confidence Interval

The following ICD-10 CM diagnosis codes were used to define ischemic stroke: ICD-10 CM diagnosis codes I60-I62

 


 

Length of Stay - Ischemic Stroke Listed as Primary Diagnosis

Length of Stay  Days  Standard Deviation
  Average Length of Stay  4.3  ±4.3
  Median Length of Stay  3
  Most Frequent Length of Stay  2

Standard deviation applies only to average

The following ICD-10 CM diagnosis codes were used to define ischemic stroke: ICD-10 CM diagnosis codes I60-I62

 


 

Hemorrhagic Stroke Listed as Primary Diagnosis per 100,000 Michigan Adults (18 Years and Older)

 Characteristics  Hospital Discharges per 100,000 Michigan Adults  95% CI
   Michigan (Rate Unadjusted)  51.1  (49.5-52.7)
   Michigan (Rate Age-Adjusted)  43.2  (42.3- 44.2)
     
 Characteristics (Rate Unadjusted)    
 Age Group (Years)    
   18-44  8.7  (7.8-9.7)
   45-64  46.4  (43.8-48.9)
   65 and Older  145.2  (139.4-151.0)
     
 Gender    
   Male  52.3  (50.0-54.6)
   Female  50.0  (47.8-52.2)
     
 Race    
   Non-Hispanic White  49.0  (47.2-50.8)
   Non-Hispanic Black  83.3  (77.8-88.8)

95% CI = 95% Confidence Interval

The following ICD-10 CM diagnosis codes were used to define hemorrhagic stroke: ICD-10 CM diagnosis codes 163, I65, and I66

 


Length of Stay - Hemorrhagic Stroke Listed as Primary Diagnosis

Length of Stay  Days  Standard Deviation
  Average Length of Stay  8  ±8.3
  Median Length of Stay  5
  Most Frequent Length of Stay  1

Standard deviation applies only to average

The following ICD-10 CM diagnosis codes were used to define hemorrhagic stroke: ICD-10 CM diagnosis codes I63, I65, and I66

 


 

Data Sources and Reference

Michigan Resident Inpatient Files created using data from the Michigan Inpatient Database (MIDB), obtained with permission from the Michigan Health & Hospital Association Service Corporation, 2017.

Usage rights: Portions of these data are taken from a proprietary database owned and maintained by the Michigan Health & Hospital Association Service Corporation (MHASC). All rights reserved. This data may not be used for commercial purposes without first obtaining written permission from the MHASC. Contact MHASC at datakoala@mha.org for more information.

United States Department of Health and Human Services (U.S. DHHS), Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Bridged-Race Population Estimates, United States July 1st resident population by state, county, age, sex, bridged-race, and Hispanic origin, on CDC WONDER On-line Database (2017).

Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. Healthy People Statistical Notes, No. 20. Hyattsville, Maryland: National Center for Health Statistics. January 2001.
 

Definitions

Confidence Interval (CI): A range about a measurement within which we would expect the “true” number of hospitalizations (hospital discharges) among the population. A 95% CI can be interpreted as the following: If we took 100 measurements and calculated 100 confident intervals, we would be 95% sure that the true hospital discharge rate among the adult Michigan population would fall within a certain range 95% of the time and outside the range 5% of the time. The wider the interval, the more imprecise the measurement; the narrower the interval, the more precise the measurement.
 

Methods and Limitations

The hospitalizations per 100,000 Michigan adults (i.e., hospital discharge rates) were determined using hospital discharge counts among Michigan adults (18 years and older) as the numerator and the estimated number of Michigan adults (18 years and older) as the denominator. The Michigan Residence Inpatient Files provided data on hospital discharges. Discharges listed as primary ICD-10 CM diagnosis codes were used to define the following cardiovascular conditions:

  1. Major cardiovascular disease was defined as diseases of the heart (I00-I09, I11, I13, and I20-I51), cerebrovascular disease (I60-I69), and diseases of the arteries, arterioles and capillaries (I70-I78);
  2. Heart attack disease was defined as (I21 and I22);
  3. Heart failure was defined as I50;
  4. Coronary heart disease was defined as I20-I25;
  5. Transient ischemic attack (TIA) was defined as G45;
  6. Stroke was defined as I60-I69;
  7. Ischemic stroke was defined as I63, I65, and I66; and
  8. Hemorrhagic stroke was defined as I60-I62.

Because hospital discharges are not individual persons, the hospital discharge rates may not necessarily reflect rates of disease per person with a cardiovascular condition; that is, persons who are hospitalized more than once in a year may be counted more than once.

The denominator was estimated from the 2017 adult Michigan bridged-race population estimate. Age-adjusted rates were rates adjusted to the 2000 U.S. Standard Population using three age groups (18–44, 45–64, and 65+ years). Rates indicated as unadjusted were rates that were not age-adjusted. Confidence intervals were 95%.