Association Between Dehydration and Short-Term Risk of Ischemic Stroke in Patients with Atrial Fibrillation

• Published in: Translational stroke research 2017-04, Vol.8 (2), p.122-130
• Main Authors: Swerdel, Joel N., Janevic, Teresa M., Kostis, William J., Faiz, Ambarina, Cosgrove, Nora M., Kostis, John B.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Aneurysms; Atrial Fibrillation - complications; Atrial Fibrillation - epidemiology; Biomedical and Life Sciences; Biomedicine; Blood clots; Brain Ischemia - complications; Brain Ischemia - epidemiology; Cardiac arrhythmia; Cardiology; Chronic obstructive pulmonary disease; Codes; Comorbidity; Dehydration; Dehydration - complications; Dehydration - epidemiology; Disease prevention; Embolisms; Female; Heart attacks; Heart failure; Hospitalization; Hospitals; Humans; Hydration; Hypertension; Ischemia; Male; Middle Aged; Mortality; Neurology; Neurosciences; Neurosurgery; Original Article; Patients; Risk Factors; Stroke; Stroke - complications; Stroke - epidemiology; Thromboembolism; Thrombosis; Vascular Surgery; Veins & arteries; Young Adult
• ISSN: 1868-4483; 1868-601X
• DOI: 10.1007/s12975-016-0471-9

Previous cross-sectional studies have demonstrated a higher incidence of dehydration in patients admitted for stroke suggesting a possible association. However, the temporality of the association has not been well established. We examined whether dehydration increases the risk of ischemic stroke in patients with a recent hospitalization for atrial fibrillation (AF). Data was from 1994 to 2012 from the Myocardial Infarction Data Acquisition System (MIDAS), a repository of in-patient records New Jersey hospitals, for AF hospitalizations ( n  = 1,282,787). Estimates for the association between AF hospitalization with/without dehydration and ischemic stroke within 30 days post-AF discharge were determined using log-linear multivariable modeling adjusting for socio-demographic factors and comorbid conditions. Within 10 days of discharge for AF, patients 18–80 years old (YO) with comorbid dehydration had a 60 % higher risk of ischemic stroke compared to AF patients without comorbid dehydration (adjusted risk ratio (ARR) 1.60, 95 % confidence interval (CI) 1.28–2.00). Eighteen- to 80-YO patients had a 34 % higher risk of ischemic stroke in days 11–20 post-AF discharge (ARR 1.34, 95 % CI 1.04, 1.74). There was no difference in the risk of stroke in 18–80-YO patients with or without prior dehydration during days 21–30 post-AF discharge. We also found no difference in the risk of ischemic stroke during any time period in patients over 80 YO. Dehydration may be a significant risk factor for ischemic stroke in patients 18–80 YO with AF.