Mohammed Yousufuddin1, Adam C Bartley2, Mouaz Alsawas3, Heather L Sheely4, Jessica Shultz4, Paul Y Takahashi5, Nathan P Young6, M Hassan Murad7. 1. Department of Hospital Internal Medicine, Mayo Clinic Health System, Austin, Minnesota. Electronic address: Yousufuddin.mohammed@Mayo.edu. 2. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota. 3. Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota. 4. Department of Hospital Internal Medicine, Mayo Clinic Health System, Austin, Minnesota. 5. Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota. 6. Division of Neurology, Mayo Clinic, Rochester, Minnesota. 7. Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota; Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
Abstract
BACKGROUND: The prevalence and clinical impact of chronic conditions (CCs) have increasingly been recognized as an important public health concern. We evaluated the prevalence of coexisting CCs and their association with 30-day mortality and readmission in hospitalized patients with stroke and transient ischemic attack (TIA). METHODS: In a retrospective study of patients aged ≥18 years hospitalized for first-ever stroke and TIA, we assessed the prevalence of coexisting CCs and their predictive value for subsequent 30-day mortality and readmission. RESULTS: Study cohort comprised 6771 patients, hospitalized for stroke (n = 4068) and TIA (n = 2703), 51.4% men, with mean age of 68.2 years (standard deviation: ±15.6), mean number of CCs of 2.9 (±1.7), 30-day mortality rate of 8.6% (entire cohort), and 30-day readmission rate of 9.7% (in 2498 patients limited to Olmsted and surrounding counties). In multivariable models, significant predictors of (1) 30-day mortality were coexisting heart failure (HF) (odds ratio [OR]: 1.45, 95% confidence interval [CI]: 1.09-1.92), cardiac arrhythmia (OR: 1.74, 95% CI: 1.40-2.17), coronary artery disease (CAD) (OR: 1.64, 95% CI: 1.29-2.08), cancer (OR: 1.67, 95% CI: 1.31-2.14), and diabetes (HR: 1.28, 95% CI: 1.01-1.62); and (2) 30-day readmission (n = 2498) were CAD (OR: 1.50, 95% CI: 1.09-2.07), cancer (OR: 1.46, 95% CI: 1.01-2.10), and arthritis (OR: 1.62, 95% CI: 1.09-2.40). CONCLUSIONS: In patients hospitalized with stroke and TIA, CCs are highly prevalent and influence 30-day mortality and readmission. Optimal therapeutic and lifestyle interventions for CAD, HF, cardiac arrhythmia, cancer, diabetes, and arthritis may improve early clinical outcome.
BACKGROUND: The prevalence and clinical impact of chronic conditions (CCs) have increasingly been recognized as an important public health concern. We evaluated the prevalence of coexisting CCs and their association with 30-day mortality and readmission in hospitalized patients with stroke and transient ischemic attack (TIA). METHODS: In a retrospective study of patients aged ≥18 years hospitalized for first-ever stroke and TIA, we assessed the prevalence of coexisting CCs and their predictive value for subsequent 30-day mortality and readmission. RESULTS: Study cohort comprised 6771 patients, hospitalized for stroke (n = 4068) and TIA (n = 2703), 51.4% men, with mean age of 68.2 years (standard deviation: ±15.6), mean number of CCs of 2.9 (±1.7), 30-day mortality rate of 8.6% (entire cohort), and 30-day readmission rate of 9.7% (in 2498 patients limited to Olmsted and surrounding counties). In multivariable models, significant predictors of (1) 30-day mortality were coexisting heart failure (HF) (odds ratio [OR]: 1.45, 95% confidence interval [CI]: 1.09-1.92), cardiac arrhythmia (OR: 1.74, 95% CI: 1.40-2.17), coronary artery disease (CAD) (OR: 1.64, 95% CI: 1.29-2.08), cancer (OR: 1.67, 95% CI: 1.31-2.14), and diabetes (HR: 1.28, 95% CI: 1.01-1.62); and (2) 30-day readmission (n = 2498) were CAD (OR: 1.50, 95% CI: 1.09-2.07), cancer (OR: 1.46, 95% CI: 1.01-2.10), and arthritis (OR: 1.62, 95% CI: 1.09-2.40). CONCLUSIONS: In patients hospitalized with stroke and TIA, CCs are highly prevalent and influence 30-day mortality and readmission. Optimal therapeutic and lifestyle interventions for CAD, HF, cardiac arrhythmia, cancer, diabetes, and arthritis may improve early clinical outcome.
Authors: Tiberiu A Pana; Adrian D Wood; Jesus A Perdomo-Lampignano; Somsak Tiamkao; Allan B Clark; Kannikar Kongbunkiat; Joao H Bettencourt-Silva; Kittisak Sawanyawisuth; Narongrit Kasemsap; Mamas A Mamas; Phyo K Myint Journal: Heart Asia Date: 2019-04-20
Authors: Mohammed Yousufuddin; Nathan Young; Lawrence Keenan; Tammy Olson; Jessica Shultz; Taylor Doyle; Eimad Ahmmad; Kogulavadanan Arumaithurai; Paul Takahashi; Mohammad Hassan Murad Journal: Brain Behav Date: 2017-11-22 Impact factor: 2.708
Authors: Mohammed Yousufuddin; Paul Y Takahashi; Brittny Major; Eimad Ahmmad; Hossam Al-Zubi; Jessica Peters; Taylor Doyle; Kelsey Jensen; Ruaa Y Al Ward; Umesh Sharma; Ashok Seshadri; Zhen Wang; Vinaya Simha; M Hassan Murad Journal: BMJ Open Date: 2019-12-15 Impact factor: 2.692
Authors: Mohammed Yousufuddin; Ye Zhu; Ruaa Al Ward; Jessica Peters; Taylor Doyle; Kelsey L Jensen; Zhen Wang; Mohammad Hassan Murad Journal: Open Heart Date: 2020-03-17