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Outcomes of Medicare beneficiaries hospitalised with transient ischaemic attack and stratification using the ABCD^(2) score

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Stroke & Vascular Neurology 2021年第2期6卷 314-318页

作者： Shreyansh Shah Li Liang Durgesh Bhandary saga johansson Eric E Smith Deepak L Bhatt Gregg C Fonarow Naeem D Khan Eric Peterson Janet Prvu Bettger Department of Neurology Duke University School of MedicineDurhamNorth CarolinaUSA Duke Clinical Research Institute DurhamNorth CarolinaUSA AstraZeneca UK Ltd CambridgeUK Hotchkiss Brain Institute and Department of Clinical Neurosciences University of CalgaryCalgaryAlbertaCanada Division of Cardiology Brigham and Women's HospitalBostonMassachusettsUSA Division of Cardiology Ronald Reagan UCLA Medical CenterLos AngelesCaliforniaUSA

Background Long-term outcomes for Medicare beneficiaries hospitalised with transient ischaemic attack(TIA)and role of ABCD^(2) score in identifying high-risk individuals are not *** We identified 40825 Medicare beneficiaries hospitalised from 2011 to 2014 for a TIA to a Get With The Guidelines(GWTG)-Stroke hospital and classified them using ABCD^(2)s 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 *** Of the 40825 patients,35118(86%)were high risk(ABCD^(2)≥4)and 5707(14%)were low risk(ABCD^(2)=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 *** with ABCD^(2) 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 ABCD^(2) score≥4 vs *** contrast,haemorrhagic stroke,myocardial infarction,gastrointestinal bleeding and intracranial haemorrhage risk were not significantly different by ABCD^(2) *** This study validates the use of ABCD^(2) score for long-term risk assessment after TIA in patients aged 65 years and *** efforts for community-based follow-up care after TIA are needed for ongoing prevention in Medicare beneficiaries who were hospitalised for TIA.

关键词： admitted score prevention

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