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Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD2 score.

Publication ,  Journal Article
Shah, S; Liang, L; Bhandary, D; Johansson, S; Smith, EE; Bhatt, DL; Fonarow, GC; Khan, ND; Peterson, E; Bettger, JP
Published in: Stroke Vasc Neurol
June 2021

BACKGROUND: Long-term outcomes for Medicare beneficiaries hospitalised with transient ischaemic attack (TIA) and role of ABCD2 score in identifying high-risk individuals are not studied. METHODS: We identified 40 825 Medicare beneficiaries hospitalised from 2011 to 2014 for a TIA to a Get With The Guidelines (GWTG)-Stroke hospital and classified them using ABCD2 score. Proportional hazards models were used to assess 1-year event rates of mortality and rehospitalisation (all-cause, ischaemic stroke, haemorrhagic stroke, myocardial infarction, and gastrointestinal and intracranial haemorrhage) for high-risk versus low-risk groups adjusted for patient and hospital characteristics. RESULTS: Of the 40 825 patients, 35 118 (86%) were high risk (ABCD2 ≥4) and 5707 (14%) were low risk (ABCD2=0-3). Overall rate of mortality during 1-year follow-up after hospital discharge for the index TIA was 11.7%, 44.3% were rehospitalised for any reason and 3.6% were readmitted due to stroke. Patients with ABCD2 score ≥4 had higher mortality at 1 year than not (adjusted HR 1.18, 95% CI 1.07 to 1.30). Adjusted risks for ischaemic stroke, all-cause readmission and mortality/all-cause readmission at 1 year were also significantly higher for patients with ABCD2 score ≥4 vs 0-3. In contrast, haemorrhagic stroke, myocardial infarction, gastrointestinal bleeding and intracranial haemorrhage risk were not significantly different by ABCD2 score. CONCLUSIONS: This study validates the use of ABCD2 score for long-term risk assessment after TIA in patients aged 65 years and older. Attentive efforts for community-based follow-up care after TIA are needed for ongoing prevention in Medicare beneficiaries who were hospitalised for TIA.

Duke Scholars

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Published In

Stroke Vasc Neurol

DOI

EISSN

2059-8696

Publication Date

June 2021

Volume

6

Issue

2

Start / End Page

314 / 318

Location

England

Related Subject Headings

  • United States
  • Stroke
  • Risk Assessment
  • Medicare
  • Ischemic Attack, Transient
  • Humans
  • Brain Ischemia
  • Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Shah, S., Liang, L., Bhandary, D., Johansson, S., Smith, E. E., Bhatt, D. L., … Bettger, J. P. (2021). Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD2 score. Stroke Vasc Neurol, 6(2), 314–318. https://doi.org/10.1136/svn-2020-000372
Shah, Shreyansh, Li Liang, Durgesh Bhandary, Saga Johansson, Eric E. Smith, Deepak L. Bhatt, Gregg C. Fonarow, Naeem D. Khan, Eric Peterson, and Janet Prvu Bettger. “Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD2 score.Stroke Vasc Neurol 6, no. 2 (June 2021): 314–18. https://doi.org/10.1136/svn-2020-000372.
Shah S, Liang L, Bhandary D, Johansson S, Smith EE, Bhatt DL, et al. Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD2 score. Stroke Vasc Neurol. 2021 Jun;6(2):314–8.
Shah, Shreyansh, et al. “Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD2 score.Stroke Vasc Neurol, vol. 6, no. 2, June 2021, pp. 314–18. Pubmed, doi:10.1136/svn-2020-000372.
Shah S, Liang L, Bhandary D, Johansson S, Smith EE, Bhatt DL, Fonarow GC, Khan ND, Peterson E, Bettger JP. Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD2 score. Stroke Vasc Neurol. 2021 Jun;6(2):314–318.

Published In

Stroke Vasc Neurol

DOI

EISSN

2059-8696

Publication Date

June 2021

Volume

6

Issue

2

Start / End Page

314 / 318

Location

England

Related Subject Headings

  • United States
  • Stroke
  • Risk Assessment
  • Medicare
  • Ischemic Attack, Transient
  • Humans
  • Brain Ischemia
  • Aged