Predictors of Recurrent Hospitalizations and the Importance of These Hospitalizations for Subsequent Mortality After Incident Transient Ischemic Attack
| Autor: | Taylor Doyle, Nathan P. Young, Kogulavadanan Arumaithurai, Kelsey Jensen, Mohammad Hassan Murad, Mohammed Yousufuddin, Karen M. Fuerstenberg, Jessica Shultz |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Statin Anemia medicine.drug_class Rate ratio Patient Readmission 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine parasitic diseases medicine Humans Medical prescription Aged Retrospective Studies business.industry Rehabilitation Hazard ratio Length of Stay Middle Aged Prognosis medicine.disease Confidence interval Ischemic Attack Transient Heart failure Female Surgery Neurology (clinical) Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 28:167-174 |
| ISSN: | 1052-3057 |
| DOI: | 10.1016/j.jstrokecerebrovasdis.2018.09.028 |
| Popis: | Background We examined predictors of recurrent hospitalizations and the importance of these hospitalizations for subsequent mortality after incident transient ischemic attacks (TIA) that have not yet been investigated. Methods Adults hospitalized for TIA from 2000 through 2017 were examined for recurrent hospitalizations, days, and percentage of time spent hospitalized and long-term mortality. Results Of 266 patients hospitalized for TIA, 122 died, 212 had 826 anycondition hospitalization (59 from TIA-related conditions) corresponding to 3384 inpatient days during 1693 person-years of follow-up. Of 42 patient-level characteristics, age greater than or equal to 65 years (Incidence rate ratio [IRR] 1.75, 95% confidence interval [CI] 1.19-2.55), current smoking (IRR 2.15, 95% CI 1.39-3.33), concurrent heart failure (IRR 1.81, 95% CI 1.17-2.80) or anemia (IRR 1.90, 95% CI 1.40-2.48), and no prescription statin (IRR 1.45, 95% CI 1.04-2.03, P = .0289) emerged as significant predictors of anycondition rehospitalization. All these variables except heart failure remained significant predictors of TIA-related rehospitalizations. All-cause mortality was significantly increased after each hospitalization from anycondition (hazard ratio [HR] 1.32, 95% CI 1.26-1.39), TIA-related condition (HR 1.72; 95% CI 1.28-2.30), and per each day (HR 1.05, 95% CI 1.04-1.05) and per 1% of follow-up time spent hospitalized from anycondition (HR 1.45, 95% CI 1.34-1.58). Conclusions Older age, current tobacco smoking, concurrent heart failure or anemia, and no prescription statin, easily measured patient-level characteristics, identifies patients with TIA at high risk for recurrent hospitalizations and the burden of these hospitalizations predicts subsequent mortality. |
| Databáze: | OpenAIRE |
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