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

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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.

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Authors’ Contributions

JS conceived of the study, performed the statistical analyses, and drafted the manuscript. TJ, WK, AF, NC, and JK participated in study design and in the draft of the manuscript. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. The Cardiovascular Institute at Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Suite 5200, New Brunswick, NJ, 08901, USA

    Joel N. Swerdel, Nora M. Cosgrove & John B. Kostis

  2. Department of Epidemiology, Rutgers University School of Public Health, Piscataway, NJ, 08854, USA

    Joel N. Swerdel & Teresa M. Janevic

  3. Division of Cardiovascular Disease and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA

    William J. Kostis

  4. Division of Hematology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA

    Ambarina Faiz

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  1. Joel N. Swerdel
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  5. Nora M. Cosgrove
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  6. John B. Kostis
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Consortia

The Myocardial Infarction Data Acquisition System (MIDAS 27) Study Group

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Correspondence to Joel N. Swerdel.

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Funding

This study was funded by departmental funds.

Conflict of Interest

Joel N. Swerdel declares that he has no conflict of interest. Teresa M. Janevic declares that she has no conflict of interest. William J. Kostis declares that he has no conflict of interest. Ambarina Faiz declares that she has no conflict of interest. Nora M. Cosgrove declares that she has no conflict of interest. John B. Kostis declares that he has no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Swerdel, J.N., Janevic, T.M., Kostis, W.J. et al. Association Between Dehydration and Short-Term Risk of Ischemic Stroke in Patients with Atrial Fibrillation. Transl. Stroke Res. 8, 122–130 (2017). https://doi.org/10.1007/s12975-016-0471-9

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  • DOI: https://doi.org/10.1007/s12975-016-0471-9

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