Division of Hospital Medicine Mayo Clinic Health System Austin MN USA.
Division of Neurology Mayo Clinic Rochester MN USA.
Brain Behav. 2017 Nov 22;7(12):e00865. doi: 10.1002/brb3.865. eCollection 2017 Dec.
The implications of early readmission on long-term mortality after transient ischemic attack (TIA) are not known. We aimed at examining the effect of 180-day readmission on subsequent long-term mortality after index hospitalization for TIA.
A retrospective study of patients hospitalized for first-ever TIA at Mayo Clinic from 2000 through 2017. Patients readmitted within 180 days postdischarge were compared with those not readmitted in long-term risk of death.
Of 251 TIA patients aged 73 ± 15 years with 1509 person-years of follow-up, 65 (26%) were readmitted within 180 days of discharge and 125 died during a median follow-up of 5.7 years. The mortality was 10 vs. 7 deaths per 100 person-years in patients who were readmitted compared to those who were not readmitted with hazard ratio (HR) 1.73 (95% confidence interval [CI] 1.13-2.66). Other competing predictors of mortality were age ≥65 years (HR 5.70, 95% CI 2.72-11.96), cancer (HR 1.65, 95% CI 1.03-3.38), chronic obstructive pulmonary disease (HR 1.90, 95% CI 1.07-3.38), heart failure (HR 3.03, 95% CI 1.82-5.06), dementia (HR 5.87, 95% CI 3.27-10.52), creatinine ≥1.4 mg/dl (HR 1.89, 95% CI 1.17-3.06), and hemoglobin level <10 g/dl (HR 2.80, 95% CI 1.20-6.66).
Hospital readmission within 180 days of discharge from index TIA was associated with increased risk of death several years after initial readmission. Older age and several comorbidities identified during index hospitalization also confer increased risk for long-term mortality.
短暂性脑缺血发作（TIA）后早期再入院对长期死亡率的影响尚不清楚。我们旨在研究 TIA 指数住院后 180 天内再入院对随后长期死亡率的影响。
这是一项对 2000 年至 2017 年在梅奥诊所因首次 TIA 住院的患者进行的回顾性研究。将出院后 180 天内再入院的患者与未再入院的患者进行比较，以评估长期死亡风险。
在 251 例年龄 73±15 岁、随访 1509 人年的 TIA 患者中，65 例（26%）在出院后 180 天内再入院，125 例在中位随访 5.7 年后死亡。再入院患者的死亡率为每 100 人年 10 例死亡，而非再入院患者的死亡率为每 100 人年 7 例死亡，风险比（HR）为 1.73（95%置信区间 [CI] 1.13-2.66）。死亡率的其他竞争预测因素包括年龄≥65 岁（HR 5.70，95% CI 2.72-11.96）、癌症（HR 1.65，95% CI 1.03-3.38）、慢性阻塞性肺疾病（HR 1.90，95% CI 1.07-3.38）、心力衰竭（HR 3.03，95% CI 1.82-5.06）、痴呆（HR 5.87，95% CI 3.27-10.52）、肌酐≥1.4mg/dl（HR 1.89，95% CI 1.17-3.06）和血红蛋白水平<10g/dl（HR 2.80，95% CI 1.20-6.66）。
TIA 指数出院后 180 天内再入院与初始再入院后数年死亡风险增加相关。指数住院期间确定的年龄较大和几种合并症也会增加长期死亡率的风险。
