Death and rehospitalization after transient ischemic attack or acute ischemic stroke: one-year outcomes from the adherence evaluation of acute ischemic stroke-longitudinal registry.

Published

Journal Article

BACKGROUND: Longitudinal data directly comparing the rates of death and rehospitalization of patients discharged after transient ischemic attack (TIA) versus acute ischemic stroke (AIS) are lacking. METHODS: Data were analyzed from 2802 patients (TIA n = 552; AIS n = 2250) admitted to 100 U.S. hospitals participating in the Get With The Guidelines-Stroke and the Adherence Evaluation of Acute Ischemic Stroke-Longitudinal registry. The primary composite outcome was the adjusted rate of all-cause death and rehospitalization over 1 year after discharge. Four additional single or combined outcomes were explored. RESULTS: Compared with AIS, TIA patients were older (median 69 v 66 years; P = .007) and more likely female (53.3% v 44.2%; P < .0001). Secondary prevention medication use after hospital discharge was less intensive after TIA, with underuse for both conditions. All-cause death or rehospitalization at 1 year was similar for TIA and AIS patients (37.7% v 34.6%; P = .271); the frequency for TIA patients was higher after covariate adjustment (hazard ratio [HR] 1.19; 95% confidence interval [CI] 1.01-1.41). One-year all-cause mortality was similar among those with TIA compared to AIS patients (3.8% v 5.7%; P = .071; adjusted HR 0.86; 95% CI 0.52-1.42). All-cause rehospitalizations were higher for TIA compared to AIS patients (36.4% v 33.0%; P = .186; adjusted HR 1.20; 95% CI 1.02-1.42), but similar for stroke rehospitalizations (10.1% v 7.4%; P = .037; adjusted HR 1.38, 95% CI 0.997-1.92). CONCLUSIONS: Patients with TIA have similar or worse 12-month postdischarge risk of death or rehospitalization as compared with those with AIS. Outcomes after TIA and AIS might be improved with better adherence to secondary preventive guidelines.

Full Text

Duke Authors

Cited Authors

  • Olson, DM; Cox, M; Pan, W; Sacco, RL; Fonarow, GC; Zorowitz, R; Labresh, KA; Schwamm, LH; Williams, L; Goldstein, LB; Bushnell, CD; Peterson, ED; Adherence Evaluation of Acute Ischemic Stroke–Longitudinal AVAIL Registry,

Published Date

  • October 2013

Published In

Volume / Issue

  • 22 / 7

Start / End Page

  • e181 - e188

PubMed ID

  • 23273788

Pubmed Central ID

  • 23273788

Electronic International Standard Serial Number (EISSN)

  • 1532-8511

Digital Object Identifier (DOI)

  • 10.1016/j.jstrokecerebrovasdis.2012.11.001

Language

  • eng

Conference Location

  • United States