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Outcomes of transient ischemic attack in maintenance dialysis patients and those with chronic kidney disease.
Nephrol Dial Transplant. 2016 Jan; 31(1):128-32.ND

Abstract

BACKGROUND

In-hospital outcomes of transient ischemic attack (TIA) in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) requiring maintenance dialysis are largely unknown. We evaluated TIA-related in-hospital outcomes in these patients using a national database.

METHODS

Our study is observational in nature. Data from all adult (≥ 18 years) patients admitted to US hospitals between 2005 and 2011 with a primary discharge diagnosis of TIA and secondary diagnosis of CKD and ESRD were included using the Nationwide In-Patient Sample. We aimed to compare the following TIA-related outcomes between CKD and ESRD patients: (i) degree of disability (mainly functional status) derived from discharge destination, (ii) length of stay, (iii) charges of hospitalization, and (iv) mortality. The comparisons of TIA-related mortality and discharge outcomes between CKD and ESRD were analyzed after adjusting for potential confounders using logistic regression analysis. We adjusted for age, sex, co-morbidities, hospital size and hospital teaching status.

RESULTS

A total of 18 316 dialysis and 67 256 CKD patients were admitted with TIA in the study period (2005-11). On univariate analysis, there was no difference in the rates of moderate-to-severe disability (20.5% versus 20.2%, P = 0.7) and in-hospital mortality (0.4% versus 0.2%, P = 0.07) in ESRD patients compared with those with CKD. After adjusting for age, sex and potential confounders, ESRD patients with TIA had higher odds of moderate-to-severe disability at discharge [odds ratio (OR): 1.53, 95% confidence interval (CI): 1.37-1.71, P ≤ 0.0001] and in-hospital death (OR: 2.87, 95% CI: 1.29-6.37, P = 0.009).

CONCLUSION

ESRD patients with TIA have significantly higher rates of moderate-to-severe disability at discharge and in-hospital mortality when compared with the patients of other stages of CKD who are not dialysis-dependent.

Authors+Show Affiliations

Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH, USA.Department of Neurology, Ochsner Clinic Foundation and Ochsner Neuroscience Institute, New Orleans, LA, USA.Department of Neurology, Ochsner Clinic Foundation and Ochsner Neuroscience Institute, New Orleans, LA, USA.Integris South west hospital, Oklahoma City, OK, USA.Department of Neurology, Emory Healthcare, Atlanta, GA, USA.Department of Emergency Medicine, Shifa International Hospital, Islamabad, Pakistan.Department of Nephrology and Hypertension, Cleveland Clinic, Cleveland, OH, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26160895

Citation

Saeed, Fahad, et al. "Outcomes of Transient Ischemic Attack in Maintenance Dialysis Patients and Those With Chronic Kidney Disease." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 31, no. 1, 2016, pp. 128-32.
Saeed F, Adil MM, Vidal GA, et al. Outcomes of transient ischemic attack in maintenance dialysis patients and those with chronic kidney disease. Nephrol Dial Transplant. 2016;31(1):128-32.
Saeed, F., Adil, M. M., Vidal, G. A., Piracha, B. H., Nahab, F., Khan, A. S., & Navaneethan, S. D. (2016). Outcomes of transient ischemic attack in maintenance dialysis patients and those with chronic kidney disease. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 31(1), 128-32. https://doi.org/10.1093/ndt/gfv246
Saeed F, et al. Outcomes of Transient Ischemic Attack in Maintenance Dialysis Patients and Those With Chronic Kidney Disease. Nephrol Dial Transplant. 2016;31(1):128-32. PubMed PMID: 26160895.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of transient ischemic attack in maintenance dialysis patients and those with chronic kidney disease. AU - Saeed,Fahad, AU - Adil,Malik M, AU - Vidal,Gabriel A, AU - Piracha,Bilal Hussain, AU - Nahab,Fadi, AU - Khan,Abdus Salam, AU - Navaneethan,Sankar D, Y1 - 2015/07/09/ PY - 2015/01/19/received PY - 2015/05/13/accepted PY - 2015/7/11/entrez PY - 2015/7/15/pubmed PY - 2016/8/17/medline KW - chronic kidney disease KW - dialysis KW - transient ischemic attack SP - 128 EP - 32 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 31 IS - 1 N2 - BACKGROUND: In-hospital outcomes of transient ischemic attack (TIA) in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) requiring maintenance dialysis are largely unknown. We evaluated TIA-related in-hospital outcomes in these patients using a national database. METHODS: Our study is observational in nature. Data from all adult (≥ 18 years) patients admitted to US hospitals between 2005 and 2011 with a primary discharge diagnosis of TIA and secondary diagnosis of CKD and ESRD were included using the Nationwide In-Patient Sample. We aimed to compare the following TIA-related outcomes between CKD and ESRD patients: (i) degree of disability (mainly functional status) derived from discharge destination, (ii) length of stay, (iii) charges of hospitalization, and (iv) mortality. The comparisons of TIA-related mortality and discharge outcomes between CKD and ESRD were analyzed after adjusting for potential confounders using logistic regression analysis. We adjusted for age, sex, co-morbidities, hospital size and hospital teaching status. RESULTS: A total of 18 316 dialysis and 67 256 CKD patients were admitted with TIA in the study period (2005-11). On univariate analysis, there was no difference in the rates of moderate-to-severe disability (20.5% versus 20.2%, P = 0.7) and in-hospital mortality (0.4% versus 0.2%, P = 0.07) in ESRD patients compared with those with CKD. After adjusting for age, sex and potential confounders, ESRD patients with TIA had higher odds of moderate-to-severe disability at discharge [odds ratio (OR): 1.53, 95% confidence interval (CI): 1.37-1.71, P ≤ 0.0001] and in-hospital death (OR: 2.87, 95% CI: 1.29-6.37, P = 0.009). CONCLUSION: ESRD patients with TIA have significantly higher rates of moderate-to-severe disability at discharge and in-hospital mortality when compared with the patients of other stages of CKD who are not dialysis-dependent. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/26160895/Outcomes_of_transient_ischemic_attack_in_maintenance_dialysis_patients_and_those_with_chronic_kidney_disease_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfv246 DB - PRIME DP - Unbound Medicine ER -