Stroke Symptoms as a Predictor of Future Hospitalization

Virginia J. Howard, Monika M. Safford, Shauntice Allen, Suzanne E. Judd, J. David Rhodes, Dawn O. Kleindorfer, Elsayed Z. Soliman, James F Meschia, George Howard

Research output: Contribution to journalArticle

Abstract

Background Stroke symptoms in the general adult population are common and associated with stroke risk factors, lower physical and mental functioning, impaired cognitive status, and future stroke. Our objective was to determine the association of stroke symptoms with self-reported hospitalization or emergency department (ED) visit. Methods Lifetime history of stroke symptoms (sudden weakness, numbness, unilateral or general loss of vision, loss of ability to communicate or understand) was assessed at baseline in a national, population-based, longitudinal cohort study of 30,239 blacks and whites younger than 45 years, enrolled from 2003 to 2007. Self-reported hospitalization or ED visit and reason were collected during follow-up through March 2013. The symptom-hospitalization association was assessed by proportional hazards analysis in persons who were stroke/transient ischemic attack-free at baseline (27,126) with adjustment for sociodemographics and further adjustment for risk factors. Results One or more stroke symptoms were reported by 4758 (17.5%). After adjustment for sociodemographics, stroke symptoms were most strongly associated with greater risk of hospitalization/ED for cardiovascular disease (CVD) (hazard ratio [HR] = 1.87, 95% confidence interval [CI]: 1.78-1.96), stroke (HR = 1.69, 95% CI: 1.55-1.85), and any reason (HR = 1.39, 95% CI: 1.34-1.44). These associations remained significant and only modestly reduced after risk factor adjustment. Conclusions Stroke symptoms are a marker for future hospitalization and ED visit not only for stroke but also for CVD in general. Findings suggest a role for stroke symptom assessment as a novel and simple approach for identifying individuals at high risk for CVD including stroke in whom preventive strategies could be implemented.

Original languageEnglish (US)
Pages (from-to)702-709
Number of pages8
JournalJournal of Stroke and Cerebrovascular Diseases
Volume25
Issue number3
DOIs
StatePublished - Mar 1 2016

Fingerprint

Hospitalization
Stroke
Hospital Emergency Service
Cardiovascular Diseases
Confidence Intervals
Risk Adjustment
Aptitude
Symptom Assessment
Hypesthesia
Transient Ischemic Attack
Population
Longitudinal Studies
Cohort Studies

Keywords

  • cardiovascular disease
  • hospitalization
  • prospective studies
  • stroke
  • Stroke symptoms

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

Cite this

Howard, V. J., Safford, M. M., Allen, S., Judd, S. E., Rhodes, J. D., Kleindorfer, D. O., ... Howard, G. (2016). Stroke Symptoms as a Predictor of Future Hospitalization. Journal of Stroke and Cerebrovascular Diseases, 25(3), 702-709. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.040

Stroke Symptoms as a Predictor of Future Hospitalization. / Howard, Virginia J.; Safford, Monika M.; Allen, Shauntice; Judd, Suzanne E.; Rhodes, J. David; Kleindorfer, Dawn O.; Soliman, Elsayed Z.; Meschia, James F; Howard, George.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 25, No. 3, 01.03.2016, p. 702-709.

Research output: Contribution to journalArticle

Howard, VJ, Safford, MM, Allen, S, Judd, SE, Rhodes, JD, Kleindorfer, DO, Soliman, EZ, Meschia, JF & Howard, G 2016, 'Stroke Symptoms as a Predictor of Future Hospitalization', Journal of Stroke and Cerebrovascular Diseases, vol. 25, no. 3, pp. 702-709. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.040
Howard, Virginia J. ; Safford, Monika M. ; Allen, Shauntice ; Judd, Suzanne E. ; Rhodes, J. David ; Kleindorfer, Dawn O. ; Soliman, Elsayed Z. ; Meschia, James F ; Howard, George. / Stroke Symptoms as a Predictor of Future Hospitalization. In: Journal of Stroke and Cerebrovascular Diseases. 2016 ; Vol. 25, No. 3. pp. 702-709.
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abstract = "Background Stroke symptoms in the general adult population are common and associated with stroke risk factors, lower physical and mental functioning, impaired cognitive status, and future stroke. Our objective was to determine the association of stroke symptoms with self-reported hospitalization or emergency department (ED) visit. Methods Lifetime history of stroke symptoms (sudden weakness, numbness, unilateral or general loss of vision, loss of ability to communicate or understand) was assessed at baseline in a national, population-based, longitudinal cohort study of 30,239 blacks and whites younger than 45 years, enrolled from 2003 to 2007. Self-reported hospitalization or ED visit and reason were collected during follow-up through March 2013. The symptom-hospitalization association was assessed by proportional hazards analysis in persons who were stroke/transient ischemic attack-free at baseline (27,126) with adjustment for sociodemographics and further adjustment for risk factors. Results One or more stroke symptoms were reported by 4758 (17.5{\%}). After adjustment for sociodemographics, stroke symptoms were most strongly associated with greater risk of hospitalization/ED for cardiovascular disease (CVD) (hazard ratio [HR] = 1.87, 95{\%} confidence interval [CI]: 1.78-1.96), stroke (HR = 1.69, 95{\%} CI: 1.55-1.85), and any reason (HR = 1.39, 95{\%} CI: 1.34-1.44). These associations remained significant and only modestly reduced after risk factor adjustment. Conclusions Stroke symptoms are a marker for future hospitalization and ED visit not only for stroke but also for CVD in general. Findings suggest a role for stroke symptom assessment as a novel and simple approach for identifying individuals at high risk for CVD including stroke in whom preventive strategies could be implemented.",
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AU - Safford, Monika M.

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AU - Rhodes, J. David

AU - Kleindorfer, Dawn O.

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N2 - Background Stroke symptoms in the general adult population are common and associated with stroke risk factors, lower physical and mental functioning, impaired cognitive status, and future stroke. Our objective was to determine the association of stroke symptoms with self-reported hospitalization or emergency department (ED) visit. Methods Lifetime history of stroke symptoms (sudden weakness, numbness, unilateral or general loss of vision, loss of ability to communicate or understand) was assessed at baseline in a national, population-based, longitudinal cohort study of 30,239 blacks and whites younger than 45 years, enrolled from 2003 to 2007. Self-reported hospitalization or ED visit and reason were collected during follow-up through March 2013. The symptom-hospitalization association was assessed by proportional hazards analysis in persons who were stroke/transient ischemic attack-free at baseline (27,126) with adjustment for sociodemographics and further adjustment for risk factors. Results One or more stroke symptoms were reported by 4758 (17.5%). After adjustment for sociodemographics, stroke symptoms were most strongly associated with greater risk of hospitalization/ED for cardiovascular disease (CVD) (hazard ratio [HR] = 1.87, 95% confidence interval [CI]: 1.78-1.96), stroke (HR = 1.69, 95% CI: 1.55-1.85), and any reason (HR = 1.39, 95% CI: 1.34-1.44). These associations remained significant and only modestly reduced after risk factor adjustment. Conclusions Stroke symptoms are a marker for future hospitalization and ED visit not only for stroke but also for CVD in general. Findings suggest a role for stroke symptom assessment as a novel and simple approach for identifying individuals at high risk for CVD including stroke in whom preventive strategies could be implemented.

AB - Background Stroke symptoms in the general adult population are common and associated with stroke risk factors, lower physical and mental functioning, impaired cognitive status, and future stroke. Our objective was to determine the association of stroke symptoms with self-reported hospitalization or emergency department (ED) visit. Methods Lifetime history of stroke symptoms (sudden weakness, numbness, unilateral or general loss of vision, loss of ability to communicate or understand) was assessed at baseline in a national, population-based, longitudinal cohort study of 30,239 blacks and whites younger than 45 years, enrolled from 2003 to 2007. Self-reported hospitalization or ED visit and reason were collected during follow-up through March 2013. The symptom-hospitalization association was assessed by proportional hazards analysis in persons who were stroke/transient ischemic attack-free at baseline (27,126) with adjustment for sociodemographics and further adjustment for risk factors. Results One or more stroke symptoms were reported by 4758 (17.5%). After adjustment for sociodemographics, stroke symptoms were most strongly associated with greater risk of hospitalization/ED for cardiovascular disease (CVD) (hazard ratio [HR] = 1.87, 95% confidence interval [CI]: 1.78-1.96), stroke (HR = 1.69, 95% CI: 1.55-1.85), and any reason (HR = 1.39, 95% CI: 1.34-1.44). These associations remained significant and only modestly reduced after risk factor adjustment. Conclusions Stroke symptoms are a marker for future hospitalization and ED visit not only for stroke but also for CVD in general. Findings suggest a role for stroke symptom assessment as a novel and simple approach for identifying individuals at high risk for CVD including stroke in whom preventive strategies could be implemented.

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