Outcomes of transient ischemic attack in maintenance dialysis patients and those with chronic kidney disease Article

Full Text via DOI: 10.1093/ndt/gfv246 PMID: 26160895 Web of Science: 000371234600019
International Collaboration

Cited authors

  • Saeed, Fahad; Adil, Malik M.; Vidal, Gabriel A.; Piracha, Bilal Hussain; Nahab, Fadi; Khan, Abdus Salam; Navaneethan, Sankar D.

Abstract

  • Background. In-hospital outcomes of transient ischemic attack (TIA) in patients with chronic kidney disease (CKD) and endstage 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 TIArelated mortality and discharge outcomes between CKD and ESRD were analyzed after adjusting for potential confounders using logistic regression analysis. We adjusted for age, sex, comorbidities, 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 inhospital mortality when compared with the patients of other stages of CKD who are not dialysis-dependent.

Publication date

  • 2016

Published in

Category

International Standard Serial Number (ISSN)

  • 0931-0509

Start page

  • 128

End page

  • 132

Volume

  • 31

Issue

  • 1