title: Association Between Dehydration and Short-Term Risk of Ischemic Stroke in Patients with Atrial Fibrillation.
abstract: 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.
authors.affiliation: The Cardiovascular Institute at Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Suite 5200, New Brunswick, NJ, 08901, USA. joel.swerdel@rutgers.edu.|Department of Epidemiology, Rutgers University School of Public Health, Piscataway, NJ, 08854, USA. joel.swerdel@rutgers.edu.
authors.forename: Joel N
authors.initials: JN
authors.lastname: Swerdel
authors.affiliation: Department of Epidemiology, Rutgers University School of Public Health, Piscataway, NJ, 08854, USA.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Janevic
authors.affiliation: Division of Cardiovascular Disease and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Kostis
authors.affiliation: Division of Hematology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA.
authors.forename: Ambarina
authors.initials: A
authors.lastname: Faiz
authors.affiliation: The Cardiovascular Institute at Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Suite 5200, New Brunswick, NJ, 08901, USA.
authors.forename: Nora M
authors.initials: NM
authors.lastname: Cosgrove
authors.affiliation: The Cardiovascular Institute at Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Suite 5200, New Brunswick, NJ, 08901, USA.
authors.forename: John B
authors.initials: JB
authors.lastname: Kostis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology*; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology*; D003681:Dehydration / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult
keywords: Cardiovascular; Dehydration; Hemorrhagic stroke; Ischemic stroke; Myocardial infarction