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

Transl Stroke Res. 2017 Apr;8(2):122-130. doi: 10.1007/s12975-016-0471-9. Epub 2016 May 23.

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.

Keywords: Cardiovascular; Dehydration; Hemorrhagic stroke; Ischemic stroke; Myocardial infarction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / epidemiology*
  • Brain Ischemia / complications
  • Brain Ischemia / epidemiology*
  • Dehydration / complications
  • Dehydration / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Stroke / complications
  • Stroke / epidemiology*
  • Young Adult