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Stroke Symptoms as a Predictor of Future Hospitalization.

TitleStroke Symptoms as a Predictor of Future Hospitalization.
Publication TypeJournal Article
Year of Publication2016
AuthorsHoward, VJ, Safford, MM, Allen, S, Judd, SE, J Rhodes, D, Kleindorfer, DO, Soliman, EZ, Meschia, JF, Howard, G
JournalJ Stroke Cerebrovasc Dis
Volume25
Issue3
Pagination702-9
Date Published2016 Mar
ISSN1532-8511
KeywordsAdolescent, Adult, Cohort Studies, Female, Hospitalization, Humans, Male, Outcome Assessment (Health Care), Predictive Value of Tests, Proportional Hazards Models, Risk Factors, Stroke, Young Adult
Abstract

BACKGROUND: Stroke symptoms in the general adult population are common and associated with stroke risk factors, lower physical and mental functioning, impaired cognitive status, and future stroke. Our objective was to determine the association of stroke symptoms with self-reported hospitalization or emergency department (ED) visit.METHODS: Lifetime history of stroke symptoms (sudden weakness, numbness, unilateral or general loss of vision, loss of ability to communicate or understand) was assessed at baseline in a national, population-based, longitudinal cohort study of 30,239 blacks and whites younger than 45 years, enrolled from 2003 to 2007. Self-reported hospitalization or ED visit and reason were collected during follow-up through March 2013. The symptom-hospitalization association was assessed by proportional hazards analysis in persons who were stroke/transient ischemic attack-free at baseline (27,126) with adjustment for sociodemographics and further adjustment for risk factors.RESULTS: One or more stroke symptoms were reported by 4758 (17.5%). After adjustment for sociodemographics, stroke symptoms were most strongly associated with greater risk of hospitalization/ED for cardiovascular disease (CVD) (hazard ratio [HR] = 1.87, 95% confidence interval [CI]: 1.78-1.96), stroke (HR = 1.69, 95% CI: 1.55-1.85), and any reason (HR = 1.39, 95% CI: 1.34-1.44). These associations remained significant and only modestly reduced after risk factor adjustment.CONCLUSIONS: Stroke symptoms are a marker for future hospitalization and ED visit not only for stroke but also for CVD in general. Findings suggest a role for stroke symptom assessment as a novel and simple approach for identifying individuals at high risk for CVD including stroke in whom preventive strategies could be implemented.

DOI10.1016/j.jstrokecerebrovasdis.2015.11.040
Alternate JournalJ Stroke Cerebrovasc Dis
PubMed ID26774871
PubMed Central IDPMC4779679
Grant ListR01 HL080477 / HL / NHLBI NIH HHS / United States
R01 NS041588 / NS / NINDS NIH HHS / United States
U01 NS041588 / NS / NINDS NIH HHS / United States
NS041588 / NS / NINDS NIH HHS / United States