Abstract 3875: Quantifying The Contribution Of Risk Factors For Ischaemic Stroke In Patients With A History Of TIA
Background: The risk of stroke is significantly greater in patients with a history of transient ischaemic attack (TIA). Here, we present a model that comprehensively quantifies individual risk for an ischaemic stroke within 30-days after a TIA.
Methods: We conducted a retrospective analysis of 57,585 TIA admissions to 155 United States hospitals. For each admission, we gathered demographic data, diagnostic and procedural codes, and length of stay; we collected the zip code and primary stroke center (PSC) certification status of each hospital. We used this information to build hierarchal regression models to study the risk of stroke readmission in TIA patients.
Results: The prevalence of 30-day ischaemic stroke readmissions was 11 per 1,000 TIA admissions, however most (53.2%) occurred within one week. The regression model revealed peripheral vascular disease (Odds-Ratio: 1.83), hypertensive chronic kidney disease (OR: 1.69), history of myocardial infarction (OR: 1.33), essential hypertension (OR: 1.14) and diabetes mellitus (OR: 1.2) as significant comorbid predictors that contributed to individual risk. Cerebrovascular disease was the primary readmission reason in the TIA patient population (19% of readmissions). The risk-adjusted stroke-readmission rates showed little variation among hospitals (cv = 0.06). PSC status was not significantly associated with the observed differences in stroke readmission rates among hospitals (Fisher exact, p = 0.30).
Conclusions: Cardiovascular comorbidities and diabetes mellitus are associated with significantly greater risk for a stroke readmission within 30-days of a TIA. Our results highlight the need for identifying at-risk individuals based on the profile of their comorbidities when assigning care.
- © 2012 by American Heart Association, Inc.