Effect of early hospital readmission and comorbid conditions on subsequent long-term mortality after transient ischemic attack

Mohammed Yousufuddin, Nathan Young, Lawrence Keenan, Tammy Olson, Jessica Shultz, Taylor Doyle, Eimad Ahmmad, Kogulavadanan Arumaithurai, Paul Y Takahashi, Mohammad H Murad

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: 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.

Original languageEnglish (US)
JournalBrain and Behavior
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Patient Readmission
Transient Ischemic Attack
Confidence Intervals
Mortality
Hospitalization
Chronic Obstructive Pulmonary Disease
Dementia
Comorbidity
Creatinine
Hemoglobins
Heart Failure
Retrospective Studies

Keywords

  • Chronic conditions
  • Mortality
  • Readmission
  • Transient ischemic attack

ASJC Scopus subject areas

  • Behavioral Neuroscience

Cite this

Effect of early hospital readmission and comorbid conditions on subsequent long-term mortality after transient ischemic attack. / Yousufuddin, Mohammed; Young, Nathan; Keenan, Lawrence; Olson, Tammy; Shultz, Jessica; Doyle, Taylor; Ahmmad, Eimad; Arumaithurai, Kogulavadanan; Takahashi, Paul Y; Murad, Mohammad H.

In: Brain and Behavior, 01.01.2017.

Research output: Contribution to journalArticle

Yousufuddin, Mohammed ; Young, Nathan ; Keenan, Lawrence ; Olson, Tammy ; Shultz, Jessica ; Doyle, Taylor ; Ahmmad, Eimad ; Arumaithurai, Kogulavadanan ; Takahashi, Paul Y ; Murad, Mohammad H. / Effect of early hospital readmission and comorbid conditions on subsequent long-term mortality after transient ischemic attack. In: Brain and Behavior. 2017.
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abstract = "Background: 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. Methods: 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. Results: 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). Conclusions: 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.",
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T1 - Effect of early hospital readmission and comorbid conditions on subsequent long-term mortality after transient ischemic attack

AU - Yousufuddin, Mohammed

AU - Young, Nathan

AU - Keenan, Lawrence

AU - Olson, Tammy

AU - Shultz, Jessica

AU - Doyle, Taylor

AU - Ahmmad, Eimad

AU - Arumaithurai, Kogulavadanan

AU - Takahashi, Paul Y

AU - Murad, Mohammad H

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: 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. Methods: 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. Results: 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). Conclusions: 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.

AB - Background: 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. Methods: 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. Results: 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). Conclusions: 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.

KW - Chronic conditions

KW - Mortality

KW - Readmission

KW - Transient ischemic attack

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