Use of Medicare claims data to estimate national trends in stroke incidence, 1985-1991.

May, D S; Kittner, S. J.

doi:10.1161/01.str.25.12.2343

Cited by 35 publications

(25 citation statements)

References 13 publications

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“…The incidence of cardiovascular events in unmatched population control subjects (n = 819,283) was consistent with prior studies (10.3 and 11 cases per 1,000 personyears for myocardial infarction and stroke, respectively) (23,24,26). Patients with severe sepsis had a 13-fold higher risk of cardiovascular events compared with unmatched control subjects (incidence: 498.2 versus 36 events/1,000 person-years; P , 0.0001).…”

Section: Cardiovascular Eventssupporting

confidence: 86%

“…Thus, the higher risk of CVD may be seen in a broad group of patients requiring acute care. The 1.9-fold increased risk is similar to the risk of cardiovascular events observed for smoking cigarettes, diabetes, and hypercholesterolemia (23,24,26). Our findings have important implications to understand why survivors of severe sepsis, critical illness, or acute care have high long-term mortality.…”

Section: Discussionsupporting

confidence: 60%

“…The primary outcome was hospitalization for cardiovascular events (stroke, TIA, myocardial infarction, or coronary revascularization, including percutaneous coronary intervention and coronary artery bypass graft surgery) during the first year after hospital discharge, assigned based on previously validated ICD-9 CM code-based approaches (22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

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Risk of Cardiovascular Events in Survivors of Severe Sepsis

Yende

Linde-Zwirble²,

Mayr³

et al. 2014

Am J Respir Crit Care Med

149

107

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Rationale: The risk of cardiovascular events after severe sepsis is not known, and these events may explain increased long-term mortality in survivors of severe sepsis.Objectives: To determine whether survivors of severe sepsis hospitalization have high long-term risk of cardiovascular events. We examined whether higher risk is due to severe sepsis hospitalization or poor prehospitalization health status, and if the higher risk is also observed in patients hospitalized for infectious and noninfectious reasons, and in other critically ill patients.Methods: Unmatched and matched-cohort analyses of Medicare beneficiaries. For unmatched analysis, we compared patients with severe sepsis admitted to the intensive care unit (ICU) and survived hospitalization (n = 4,179) to unmatched population control subjects (n = 819,283). For matched analysis, we propensity-scorematched each patient with severe sepsis to four control subjects (population, hospitalized, non-severe sepsis ICU control subjects, and infection hospitalization). Primary outcome was 1-year incidence rate of hospitalization for cardiovascular events.Measurements and Main Results: Cardiovascular events were common among patients discharged alive after severe sepsis hospitalization (29.5%; 498.2 events/1,000 person-years). Survivors of severe sepsis had a 13-fold higher risk of cardiovascular events compared with unmatched control subjects (498.2 vs. 36 events/1,000 person-years; P , 0.0001), and a 1.9-fold higher risk compared with matched-population control subjects (P , 0.0001). Survivors of severe sepsis had 1.1-fold higher risk compared with matched hospitalized patients and infection hospitalizations (P = 0.002 and 0.001) and similar risk compared with matched-ICU control subjects.Conclusions: Survivors of severe sepsis have high risk of cardiovascular events. The higher risk is mainly due to poor prehospitalization health status, and is also seen in a broader population of acutely ill patients.Keywords: sepsis; severe sepsis; cardiovascular disease; mortality At a Glance CommentaryScientific Knowledge on the Subject: Cardiovascular events may be an important reason for increased long-term mortality in survivors of sepsis, but the long-term risk of cardiovascular events after severe sepsis is not known.What This Study Added to the Field: This study shows that survivors of severe sepsis have high risk of cardiovascular events, but the higher risk is mainly due to poor health status before occurrence of severe sepsis, and is also seen in a broad group of patients requiring acute care.Severe sepsis occurs in over 750,000 individuals in the United States, up to 19 million individuals worldwide annually, and accounts for 10% of all intensive care unit (ICU) admissions (1-3). Survivors of severe sepsis have high long-term mortality (4), and these consequences cannot be solely explained by poor health status before the infection (5, 6). A potential mechanism to explain increased long-term mortality is worsening of pre-existing chronic diseases or emerg...

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Section: Cardiovascular Eventssupporting

confidence: 86%

Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk of Cardiovascular Events in Survivors of Severe Sepsis

Yende

Linde-Zwirble²,

Mayr³

et al. 2014

Am J Respir Crit Care Med

149

107

View full text Add to dashboard Cite

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“…Previous work has demonstrated that when these codes are listed as the primary diagnosis, they have a positive predictive value of 92% to 100%. [18][19][20][21][22] The presence of comorbidities, such as hypertension, DM, and AF on follow-up was also determined using data from CMS using a previously described methodology (Methods in the online-only Data Supplement).…”

Section: Medicare Claims Datamentioning

confidence: 99%

Association Between Midlife Cardiorespiratory Fitness and Risk of Stroke

Pandey

Patel

Willis

et al. 2016

Stroke

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Background and Purpose-Low cardiorespiratory fitness (CRF) is associated with an increased risk of stroke. However, the extent to which this association is explained by the development of stroke risk factors such as diabetes mellitus, hypertension, and atrial fibrillation is unknown. We evaluated the relationship between midlife CRF and risk of stroke after the age of 65 years, independent of the antecedent risk factor burden. Methods-Linking

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“…[8][9][10][11]22 Furthermore, many of the increases we report in disease prevalence are consistent with recent epidemiologic evidence drawing on multiple years of data. Studies vary with respect to time period, measures of disease, and target populations; however, they document recent ageadjusted increases in the incidence of heart attack, 30 stroke, 31 and several forms of cancer [32][33][34][35] and in the prevalence of diabetes 36 and obesity 37 for older Americans. Better detection may be responsible in part for increases in the incidence of stroke, 31 some forms of cancer, [32][33][34] heart disease, 38 and osteoporosis; in other cases, increases do not appear to be an artifact of diagnostic changes.…”

Section: Discussionmentioning

confidence: 99%

Contribution of chronic conditions to aggregate changes in old-age functioning

Freedman

Martin²

2000

Am J Public Health

133

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OBJECTIVES: This study explored the role of various chronic conditions in explaining recent improvements in functioning among older Americans. METHODS: We used the Supplements on Aging to the 1984 and 1994 National Health Interview Surveys to examine changes among Americans 70 years and older in reports of chronic conditions and functional limitations. We decomposed functioning changes into condition-related components, controlling for demographic shifts. RESULTS: The percentage of older Americans with upper- and lower-body limitations declined from 5.1% and 34.2%, respectively, in 1984 to 4.3% and 28.5% in 1995, and the average number of lower body limitations decreased. During the same period, reports of 8 of 9 chronic conditions increased, but many of these conditions had less debilitating effects on functioning. Reductions in the debilitating effects of various chronic conditions--particularly arthritis--are important in explaining declines in limitations experienced by older Americans. CONCLUSIONS: Earlier diagnosis and improved treatment and management of chronic conditions, rather than prevention, may be important contributing factors to improvements in upper- and lower-body functioning among older Americans.

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Use of Medicare claims data to estimate national trends in stroke incidence, 1985-1991.

Cited by 35 publications

References 13 publications

Risk of Cardiovascular Events in Survivors of Severe Sepsis

Risk of Cardiovascular Events in Survivors of Severe Sepsis

Association Between Midlife Cardiorespiratory Fitness and Risk of Stroke

Contribution of chronic conditions to aggregate changes in old-age functioning

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