Dataset Information

Trends in Transient Ischemic Attack Hospitalizations in the United States.

ABSTRACT:

Background

Transient ischemic attack (TIA) is a major predictor of subsequent stroke. No study has assessed nation-wide trends in hospitalization for TIA in the United States.

Methods and results

Temporal trends in hospitalization for TIA (International Classification of Diseases, Ninth Revision code 435.0-435.9) from 2000 to 2010 were assessed among adults aged ?25 years using the Nationwide Inpatient Sample. Age-, sex-, and race/ethnic-specific TIA hospitalization rates were calculated using the weighted number of hospitalizations as the numerator and the US population as the denominator. Age-adjusted rates were standardized to the 2000 US Census population. From 2000 to 2010, age-adjusted TIA hospitalization rates decreased from 118 to 83 per 100 000 (overall rate reduction, -29.7%). Age-specific TIA hospitalization rates increased for individuals aged 24 to 44 years (10-11 per 100 000), but decreased for individuals aged 45 to 64 (74 to 65 per 100 000), 65 to 84 (398 to 245 per 100 000), and ?85 years (900 to 619 per 100 000). Blacks had the highest age-adjusted yearly hospitalization rates, followed by Hispanics and whites (124, 82, and 67 per 100 000 in 2010). Rates slightly increased for blacks, but decreased for Hispanics and whites. Compared to women, age-adjusted TIA hospitalization rates were lower and declined more steeply in men (132 to 89 per 100 000 versus 134 to 97 per 100 000).

Conclusions

Although overall TIA hospitalizations have decreased in the United States, the reduction has been more pronounced among older individuals, men, whites, and Hispanics. These findings highlight the need to target risk-factor control among women, blacks, and individuals aged <45 years.

SUBMITTER: Ramirez L

PROVIDER: S-EPMC5079046 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Publications

Trends in Transient Ischemic Attack Hospitalizations in the United States.

Ramirez Lucas L Kim-Tenser May A MA Sanossian Nerses N Cen Steven S Wen Ge G He Shuhan S Mack William J WJ Towfighi Amytis A

Journal of the American Heart Association 20160924 9

<h4>Background</h4>Transient ischemic attack (TIA) is a major predictor of subsequent stroke. No study has assessed nation-wide trends in hospitalization for TIA in the United States.<h4>Methods and results</h4>Temporal trends in hospitalization for TIA (International Classification of Diseases, Ninth Revision code 435.0-435.9) from 2000 to 2010 were assessed among adults aged ≥25 years using the Nationwide Inpatient Sample. Age-, sex-, and race/ethnic-specific TIA hospitalization rates were cal ...[more]

PMID: 27664805

Similar Datasets

Project description:BackgroundPatients with ischemic stroke or transient ischemic attack (TIA) are at increased risk for future cardiovascular events despite current preventive therapies. The identification of insulin resistance as a risk factor for stroke and myocardial infarction raised the possibility that pioglitazone, which improves insulin sensitivity, might benefit patients with cerebrovascular disease.MethodsIn this multicenter, double-blind trial, we randomly assigned 3876 patients who had had a recent ischemic stroke or TIA to receive either pioglitazone (target dose, 45 mg daily) or placebo. Eligible patients did not have diabetes but were found to have insulin resistance on the basis of a score of more than 3.0 on the homeostasis model assessment of insulin resistance (HOMA-IR) index. The primary outcome was fatal or nonfatal stroke or myocardial infarction.ResultsBy 4.8 years, a primary outcome had occurred in 175 of 1939 patients (9.0%) in the pioglitazone group and in 228 of 1937 (11.8%) in the placebo group (hazard ratio in the pioglitazone group, 0.76; 95% confidence interval [CI], 0.62 to 0.93; P=0.007). Diabetes developed in 73 patients (3.8%) and 149 patients (7.7%), respectively (hazard ratio, 0.48; 95% CI, 0.33 to 0.69; P<0.001). There was no significant between-group difference in all-cause mortality (hazard ratio, 0.93; 95% CI, 0.73 to 1.17; P=0.52). Pioglitazone was associated with a greater frequency of weight gain exceeding 4.5 kg than was placebo (52.2% vs. 33.7%, P<0.001), edema (35.6% vs. 24.9%, P<0.001), and bone fracture requiring surgery or hospitalization (5.1% vs. 3.2%, P=0.003).ConclusionsIn this trial involving patients without diabetes who had insulin resistance along with a recent history of ischemic stroke or TIA, the risk of stroke or myocardial infarction was lower among patients who received pioglitazone than among those who received placebo. Pioglitazone was also associated with a lower risk of diabetes but with higher risks of weight gain, edema, and fracture. (Funded by the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT00091949.).

Dataset Information

Trends in Transient Ischemic Attack Hospitalizations in the United States.

Background

Methods and results

Conclusions

Publications

Trends in Transient Ischemic Attack Hospitalizations in the United States.

Similar Datasets

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