Major Research Findings

Transient ischemic attack (TIA) is a major burden not only during hospitalization but also after hospital discharge. This meta-analysis aimed to evaluate hospital readmissions, causes and risk factors after survival of acute stroke and TIA. PubMed, Web of Science, Cochrane Library, OVID and EMBASE databases were searched to identify studies reporting hospital readmissions after acute stroke and TIA. The primary outcomes were hospital readmission rates during 30 days and 1 year after discharge. The primary causes and risk factors of hospital readmissions were also identified.

Ten studies with 253,680 patients were eligible for inclusion. The pooled 30-day and 1-year hospital readmission rates were 17.4% (95% CI, 12.7-23.5%) and 42.5% (95% CI, 34.1-51.3%), respectively. The three major causes of 30-day hospital readmissions were infection (19.9%), coronary artery disease (CAD) (17.8%) and recurrent stroke (16.0%) successively, while the three major causes were recurrent stroke (19.4%), infection (19.3%) and CAD (16.3%) during 1 year's follow-up. There were more patients with CAD in readmits group than that in control group (p = 0.030). The length of index admission, defined as any eligible admission to an acute care hospital assessed in the measure for the outcome, was longer (p = 0.000) and admission National Institutes of Health Stroke Score (NIHSS) was higher (p = 0.002) in readmits group than these in control group.

In conclusion, there is high risk of early and long-term hospital readmissions after survival of acute stroke and TIA. These patients with coronary artery disease, longer length of index admission and higher NIHSS deserve deep attention after hospital discharge.

Why Causes

TIA is caused by a temporary interruption of blood flow to the brain. When blood flow to the brain is interrupted, brain cells are deprived of oxygen and nutrients, causing stroke symptoms. TIA symptoms usually disappear quickly, but they increase the risk of a future stroke.

The causes of TIA are problems in the heart, blood vessels, or blood. If there is a problem with the heart, the heart may not be able to pump blood effectively. If there is a problem with the blood vessels, the vessels may become narrowed or blocked. If there is a problem with the blood, the blood may become more likely to clot.

Common Causes

Coronary Artery Disease

Coronary artery disease is a disease in which the coronary arteries, which supply blood to the heart, become narrowed or blocked. Coronary artery disease can be a cause of TIA.

Recurrent Stroke

Recurrent stroke is when someone who has already had a stroke has another stroke. Recurrent stroke can be a cause of TIA.

Infection

Infection is caused by the body being infected with bacteria or viruses. Infection can be a cause of TIA.

Brain Aneurysm

A brain aneurysm is a bulge in a blood vessel in the brain. If a brain aneurysm ruptures, it can cause a brain hemorrhage. Brain aneurysms can be a cause of TIA. 3

Brain Arteriovenous Malformation

A brain arteriovenous malformation is a condition in which blood vessels in the brain are not formed properly, and arteries and veins are directly connected. Brain arteriovenous malformations can cause brain hemorrhage and TIA. 3

Blood Vessel Disease

Blood vessel disease includes atherosclerosis, vasculitis, and vascular malformations. These diseases can be a cause of TIA.

Heart Disease

Heart disease includes atrial fibrillation, myocardial infarction, and valvular disease. These diseases can be a cause of TIA.

Blood Disease

Blood diseases include diseases that make the blood more likely to clot. These diseases can be a cause of TIA.

Drugs

Some drugs can be a cause of TIA.

Other Causes

In addition to the above, the following may also be a cause of TIA.

• Neck muscle tension
• Stress
• Fatigue
• Smoking
• Obesity
• Diabetes
• High blood pressure
• High cholesterol

Treatment of Causes

Lifestyle Changes

Lifestyle changes, such as quitting smoking, improving diet, and getting regular exercise, are important for reducing the risk of TIA. Smoking narrows blood vessels and makes blood more likely to clot. Dietary changes should include reducing fatty foods and eating more fruits and vegetables. Regular exercise strengthens the heart and lungs and keeps blood vessels healthy.

Medications

If you have conditions such as high blood pressure, high cholesterol, or diabetes, take medication as directed by your doctor. Medications can help reduce the risk of TIA.

Surgery

If you have a condition that requires surgery, such as a brain aneurysm or brain arteriovenous malformation, have surgery. Surgery can help reduce the risk of TIA. 3

Comparison Between Studies

Commonalities Between Studies

All studies found that TIA increases the risk of early and long-term hospital readmissions.

Differences Between Studies

The main causes and risk factors for TIA readmission varied across studies.

For example, one study reported that infection was a major cause of readmission.

However, another study reported that coronary artery disease was a major cause of readmission.

Notes on Applying Research to Real Life

TIA symptoms are similar to stroke symptoms. Therefore, it is important to seek medical attention immediately if you experience TIA symptoms. TIA can cause stroke, so early treatment is crucial. TIA can occur when there are problems in the heart, blood vessels, or blood, so it is important to detect and treat these problems early. Maintain a healthy lifestyle and get regular checkups.

Limitations of Current Research

This meta-analysis was unable to fully identify the causes and risk factors for readmission in all studies. In addition, the readmission rates were not the same in all studies.

Future Research Needs

Future research should further investigate the incidence, causes, and risk factors for TIA readmission. Additionally, new strategies for TIA prevention and treatment need to be developed.

Conclusion

TIA is a serious condition that increases the risk of early and long-term hospital readmission. To reduce the risk of TIA, it is important to maintain a healthy lifestyle and get regular checkups. If you experience TIA symptoms, seek medical attention immediately. TIA can cause stroke, so early treatment is crucial.