- 作者：Jitphapa Pongmoragot ; MD* ; Douglas S. Lee ; MD ; PhD&dagger ; ; Tai Hwan Park ; MD ; PhD&Dagger ; ; Jiming Fang ; PhD§ ; ; Peter C. Austin ; PhD§ ; ; Gustavo Saposnik ; MD ; MSc ; FAHA ; FRCPC* ; ‖ ; saposnikg@smh.ca" class="auth_mail" title="E-mail the corresponding author ; on behalf of the Investigators of the Registry of the Canadian Stroke Network
- 关键词：Stroke ; heart failure ; quality of care ; outcomes
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2016
- 出版时间：May 2016
- 年：2016
- 卷：25
- 期：5
- 页码：1048-1056
- 全文大小：576 K
Methods
We included AIS patients admitted to the institutions participating in the Registry of the Canadian Stroke Network. HF was defined as history of pre-existing HF or pulmonary edema present at the time of arrival. The primary outcome was death or disability at discharge (modified Rankin Scale score >3). Secondary outcomes included disposition, death at 3 months and at 1 year, and 30-day hospital readmissions.
Results
Among 12,396 patients, HF was found in 1124 (9.1%) patients. HF was associated with higher risk of death at 30 days (24.5% versus 11.2%, P < .0001), at 1 year (44.3% versus 20.6, P < .0001), and disability at discharge (70.4% versus 56%, P < .0001). In the multivariable analysis, HF was an independent predictor of death and disability (odds ratio 1.18, 95% confidence interval [CI] 1.01-1.37), death at 30 days (hazard ratio [HR] 1.22, 95% CI 1.05-1.41), and hospital readmissions (HR 1.32, 95% CI 1.05-1.65) at 30 days. The results were unaltered when adjusting for pneumonia with the exception of death or disability at discharge.
Conclusions
In this large cohort study, HF was observed in 9.1% of AIS patients. HF is an independent predictor of death and disability and hospital readmissions after stroke at 30 days.