Disparities in the symptomatic presentation of Moyamoya disease in the United States: A nationwide all-payer analysis

Abstract Background Moyamoya disease is a chronic occlusive cerebrovascular disease that can present with either hemorrhagic or ischemic symptoms. The objective of this study was to evaluate whether the symptomatology of Moyamoya disease differs according to patient demographic groups. Methods In this study, we used the Nationwide Inpatient Sample (NIS) to investigate differences in the presentation of Moyamoya disease by age group, gender, and ethnicity from 2012 to 2016. After propensity score matching was utilized to control for overall comorbidity, the matched cohorts for each symptomatology were compared using a Chi-square test with respect to the potential risk factors of interest (i.e. age, sex, ethnicity) in order to generate multivariate reported P-values. Results A total of 4,474 patients met inclusion criteria. Patients presenting with ischemic stroke were more likely to be 65 years and older (p  Conclusions Our findings demonstrate that the distinct presentations of Moyamoya are associated with patient age, gender, and race. This is the largest study of its kind and adds to the collective understanding of this rare but life-threatening condition.