Managed Care Weekly Digest

Recent findings in transient ischemic attack described by researchers from Yale University, Medical Department

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"Rates of 30-day and 1-year hospitalization for TIA (International Classification of Diseases, 9th Revision Code 435), stroke (International Classification of Diseases, 9th Revision Codes 433, 434, and 436), coronary artery disease (International Classification of Diseases, 9th Revision Codes 410 to 414), all-cause readmission, and mortality were determined for fee-for-service Medicare patients >= 65 years of age discharged with a TIA in 2002. Cox proportional hazards models and random-effects logistic models compared outcomes with risk adjustment for demographics, medical history, comorbidities, and prior hospitalizations. The study included 122 063 TIA hospitalizations (mean age, 79.0 +/- 7.6 years; 62% women; 86% white). Men were younger but had higher rates of cardiac comorbidities than women. Women had lower unadjusted rates of stroke, coronary artery disease, and mortality at 30 days and 1 year after TIA admission. These relationships persisted in risk-adjusted analyses at 30 days for stroke (hazard ratio, 0.70; 95% CI, 0.64 to 0.77), coronary artery disease (hazard ratio, 0.86; 0.74 to 1.00), and mortality (odds ratio, 0.74; 0.68 to 0.82) as well as at 1 year for stroke (hazard ratio, 0.85; 0.81 to 0.89), coronary artery disease (hazard ratio, 0.81; 0.77 to 0.86), and mortality (odds ratio, 0.78; 0.75 to 0.81). These data suggest that women have a better prognosis than men within the first year after hospital discharge for a TIA," wrote J.H. Lichtman and colleagues, Yale University, Medical Department.

The researchers concluded: "Additional research is needed to identify factors that may explain these sex-related differences in outcomes. (Stroke. 2009; 40:2116-2122.)."

Lichtman and colleagues published their study in Stroke (Elderly Women Have Lower Rates of Stroke, Cardiovascular Events, and Mortality After Hospitalization for Transient Ischemic Attack. Stroke, 2009;40(6):2116-2122).

Additional information can be obtained by contacting J.H. Lichtman, Yale University, School Medical, Dept. of Epidemiology & Public Health, Sect Chronic Diseases Epidemiology, POB 208034, New Haven, CT 06520, USA.

The publisher of the journal Stroke can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: United States, New Haven, Angiology, Cardiology, Cardiovascular, Central Nervous System Disease, Coronary Artery Disease, Health Policy, Heart Disease, Medicare, Transient Ischemic Attack, Yale University, Medical Department.

This article was prepared by Managed Care Weekly Digest editors from staff and other reports. Copyright 2009, Managed Care Weekly Digest via NewsRx.com.