Chun Shing Kwok, Adnan I Qureshi, Josip Andelo Borovac, Maximilian Will, Konstantin Schwarz, Mark Hall, Paul Mann, Eric Holroyd, Gregory Y H Lip
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This study aims to evaluate the stroke-heart syndrome by determining the rate and predictors of readmission for cardiac disease within 30 days of hospitalization for cerebral infarction.</p><p><strong>Methods: </strong>Data from the United States Nationwide Readmissions Database (2018 to 2020) were analyzed to identify rates and factors associated with 30-day readmissions for heart disease following cerebral infarction, excluding patients with atrial fibrillation, heart failure and myocardial infarction during admission with cerebral infarction.</p><p><strong>Results: </strong>There were 3,115,850 hospital admissions for cerebral infarction, and 75,440 admissions (2.4%) were readmitted with new onset cardiac events within 30 days of discharge. This included 36,310 (1.4%) readmissions for heart failure, 35,900 (1.1%) readmissions for atrial fibrillation, 17,465 (0.5%) readmissions for acute myocardial infarction, 810 (0.03%) readmissions for ventricular arrhythmias and 700 (0.02%) readmissions for Takotsubo syndrome. Readmitted patients were older (median age of 73 years vs. 68 years, <i>p</i> < 0.001) and had a longer length of stay for initial admission (median of 4 days vs. 3 days, <i>p</i> < 0.001). The most significant predictors of readmission were elective admission (OR 2.00, 95%CI 1.89-2.13, <i>p</i> < 0.001), cancer (OR 1.91, 95%CI 1.81-2.01, <i>p</i> < 0.001), chronic kidney disease (OR 1.80, 95%CI 1.73-1.87, <i>p</i> < 0.001), previous myocardial infarction (OR 1.59, 95%CI 1.50-1.69, <i>p</i> < 0.001) and liver failure (OR 1.34, 95%CI 1.06-1.68, <i>p</i> = 0.013). Palliative care was linked to a reduced odds of readmission (OR 0.36, 95%CI 0.31-0.41, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>New cardiac-related hospital readmissions within 30 days after ischemic stroke occur in 2.4% of patients, with elective admission and cancer being a strong predictor of readmissions.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 4","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12027694/pdf/","citationCount":"0","resultStr":"{\"title\":\"Readmissions for Cardiac Disease Within 30 Days of Hospitalization for Cerebral Infarction: An Evaluation of the Stroke-Heart Syndrome Using the Nationwide Readmission Database.\",\"authors\":\"Chun Shing Kwok, Adnan I Qureshi, Josip Andelo Borovac, Maximilian Will, Konstantin Schwarz, Mark Hall, Paul Mann, Eric Holroyd, Gregory Y H Lip\",\"doi\":\"10.3390/jcdd12040116\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The stroke-heart syndrome refers to incident cardiac complications post stroke. This study aims to evaluate the stroke-heart syndrome by determining the rate and predictors of readmission for cardiac disease within 30 days of hospitalization for cerebral infarction.</p><p><strong>Methods: </strong>Data from the United States Nationwide Readmissions Database (2018 to 2020) were analyzed to identify rates and factors associated with 30-day readmissions for heart disease following cerebral infarction, excluding patients with atrial fibrillation, heart failure and myocardial infarction during admission with cerebral infarction.</p><p><strong>Results: </strong>There were 3,115,850 hospital admissions for cerebral infarction, and 75,440 admissions (2.4%) were readmitted with new onset cardiac events within 30 days of discharge. This included 36,310 (1.4%) readmissions for heart failure, 35,900 (1.1%) readmissions for atrial fibrillation, 17,465 (0.5%) readmissions for acute myocardial infarction, 810 (0.03%) readmissions for ventricular arrhythmias and 700 (0.02%) readmissions for Takotsubo syndrome. Readmitted patients were older (median age of 73 years vs. 68 years, <i>p</i> < 0.001) and had a longer length of stay for initial admission (median of 4 days vs. 3 days, <i>p</i> < 0.001). The most significant predictors of readmission were elective admission (OR 2.00, 95%CI 1.89-2.13, <i>p</i> < 0.001), cancer (OR 1.91, 95%CI 1.81-2.01, <i>p</i> < 0.001), chronic kidney disease (OR 1.80, 95%CI 1.73-1.87, <i>p</i> < 0.001), previous myocardial infarction (OR 1.59, 95%CI 1.50-1.69, <i>p</i> < 0.001) and liver failure (OR 1.34, 95%CI 1.06-1.68, <i>p</i> = 0.013). 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引用次数: 0
摘要
背景：卒中-心脏综合征是指卒中后发生的心脏并发症。本研究旨在通过确定脑梗死患者住院30天内心脏疾病再入院率和预测因素来评估卒中-心脏综合征。方法：分析美国全国再入院数据库（2018年至2020年）的数据，以确定脑梗死后30天心脏病再入院的发生率和相关因素，排除脑梗死入院期间心房颤动、心力衰竭和心肌梗死患者。结果：脑梗死住院3,115,850例，出院后30天内新发心脏事件再入院75,440例（2.4%）。其中心衰再入院36,310例（1.4%），房颤再入院35900例（1.1%），急性心肌梗死再入院17,465例（0.5%），室性心律失常再入院810例（0.03%），Takotsubo综合征再入院700例（0.02%）。再次入院的患者年龄较大（中位年龄73岁对68岁，p < 0.001），初次入院的住院时间较长（中位4天对3天，p < 0.001）。再入院最重要的预测因素是择期入院（OR 2.00, 95%CI 1.89-2.13, p < 0.001）、癌症（OR 1.91, 95%CI 1.81-2.01, p < 0.001）、慢性肾脏疾病（OR 1.80, 95%CI 1.73-1.87, p < 0.001）、既往心肌梗死（OR 1.59, 95%CI 1.50-1.69, p < 0.001）和肝功能衰竭（OR 1.34, 95%CI 1.06-1.68, p = 0.013）。姑息治疗与再入院几率降低有关（OR 0.36, 95%CI 0.31-0.41, p < 0.001）。结论：缺血性卒中后30天内新的心脏相关医院再入院率为2.4%，选择性入院和癌症是再入院的重要预测因素。
Readmissions for Cardiac Disease Within 30 Days of Hospitalization for Cerebral Infarction: An Evaluation of the Stroke-Heart Syndrome Using the Nationwide Readmission Database.
Background: The stroke-heart syndrome refers to incident cardiac complications post stroke. This study aims to evaluate the stroke-heart syndrome by determining the rate and predictors of readmission for cardiac disease within 30 days of hospitalization for cerebral infarction.
Methods: Data from the United States Nationwide Readmissions Database (2018 to 2020) were analyzed to identify rates and factors associated with 30-day readmissions for heart disease following cerebral infarction, excluding patients with atrial fibrillation, heart failure and myocardial infarction during admission with cerebral infarction.
Results: There were 3,115,850 hospital admissions for cerebral infarction, and 75,440 admissions (2.4%) were readmitted with new onset cardiac events within 30 days of discharge. This included 36,310 (1.4%) readmissions for heart failure, 35,900 (1.1%) readmissions for atrial fibrillation, 17,465 (0.5%) readmissions for acute myocardial infarction, 810 (0.03%) readmissions for ventricular arrhythmias and 700 (0.02%) readmissions for Takotsubo syndrome. Readmitted patients were older (median age of 73 years vs. 68 years, p < 0.001) and had a longer length of stay for initial admission (median of 4 days vs. 3 days, p < 0.001). The most significant predictors of readmission were elective admission (OR 2.00, 95%CI 1.89-2.13, p < 0.001), cancer (OR 1.91, 95%CI 1.81-2.01, p < 0.001), chronic kidney disease (OR 1.80, 95%CI 1.73-1.87, p < 0.001), previous myocardial infarction (OR 1.59, 95%CI 1.50-1.69, p < 0.001) and liver failure (OR 1.34, 95%CI 1.06-1.68, p = 0.013). Palliative care was linked to a reduced odds of readmission (OR 0.36, 95%CI 0.31-0.41, p < 0.001).
Conclusions: New cardiac-related hospital readmissions within 30 days after ischemic stroke occur in 2.4% of patients, with elective admission and cancer being a strong predictor of readmissions.
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