Background Long-term outcomes for Medicare beneficiaries hospitalised with transient ischaemic attack (TIA) and role of ABCD2 score in identifying high-risk individuals are not studied. Methods We identified 40 825 Medicare beneficiaries hospitalised from 2011 to 2014 for a TIA to a Get With The Guidelines (GWTG)-Stroke hospital and classified them using ABCD2 score. Proportional hazards models were used to assess 1-year event rates of mortality and rehospitalisation (all-cause, ischaemic stroke, haemorrhagic stroke, myocardial infarction, and gastrointestinal and intracranial haemorrhage) for high-risk versus low-risk groups adjusted for patient and hospital characteristics. Results Of the 40 825 patients, 35 118 (86%) were high risk (ABCD2 ≥4) and 5707 (14%) were low risk (ABCD2=0–3). Overall rate of mortality during 1-year follow-up after hospital discharge for the index TIA was 11.7%, 44.3% were rehospitalised for any reason and 3.6% were readmitted due to stroke. Patients with ABCD2 score ≥4 had higher mortality at 1 year than not (adjusted HR 1.18, 95% CI 1.07 to 1.30). Adjusted risks for ischaemic stroke, all-cause readmission and mortality/all-cause readmission at 1 year were also significantly higher for patients with ABCD2 score ≥4 vs 0–3. In contrast, haemorrhagic stroke, myocardial infarction, gastrointestinal bleeding and intracranial haemorrhage risk were not significantly different by ABCD2 score. Conclusions This study validates the use of ABCD2 score for long-term risk assessment after TIA in patients aged 65 years and older. Attentive efforts for community-based follow-up care after TIA are needed for ongoing prevention in Medicare beneficiaries who were hospitalised for TIA.

中文翻译：

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因短暂性脑缺血发作住院的医疗保险受益人结果和使用 ABCD2 评分分层

背景 未研究因短暂性脑缺血发作 (TIA) 住院的医疗保险受益人的长期结果以及 ABCD2 评分在识别高危个体中的作用。方法 我们确定了 2011 年至 2014 年因 TIA 住院的 40 825 名 Medicare 受益人，并使用 ABCD2 评分对他们进行分类。比例风险模型用于评估针对患者和医院调整的高风险组与低风险组的 1 年死亡率和再住院事件发生率（全因、缺血性卒中、出血性卒中、心肌梗死以及胃肠道和颅内出血）特征。结果 40 825 例患者中，35 118 例（86%）为高危（ABCD2 ≥4），5707 例（14%）为低危（ABCD2=0-3）。出院后 1 年随访期间 TIA 指数的总体死亡率为 11.7%，44.3% 因任何原因再次住院，3.6% 因中风再次入院。ABCD2 评分≥4 的患者 1 年死亡率高于其他患者（调整后的 HR 1.18，95% CI 1.07 至 1.30）。对于 ABCD2 评分≥4 和 0-3 的患者，缺血性卒中、全因再入院和 1 年死亡率/全因再入院的调整风险也显着更高。相比之下，出血性中风、心肌梗死、胃肠道出血和颅内出血风险在 ABCD2 评分方面没有显着差异。结论 本研究验证了 ABCD2 评分在 65 岁及以上患者 TIA 后长期风险评估中的应用。