{"doi":"10.1161/strokeaha.122.042265","title":"Associations Between Long-Term Air Pollutant Exposure and 30-Day All-Cause Hospital Readmissions in US Patients With Stroke","abstract":"Background: Long-term exposure to air pollutants is associated with increased stroke incidence, morbidity, and mortality; however, research on the association of pollutant exposure with poststroke hospital readmissions is lacking. Methods: We assessed associations between average annual carbon monoxide (CO), nitrogen dioxide (NO 2 ), ozone (O 3 ), particulate matter 2.5, and sulfur dioxide (SO 2 ) exposure and 30-day all-cause hospital readmission in US fee-for-service Medicare beneficiaries age ≥65 years hospitalized for ischemic stroke in 2014 to 2015. We fit Cox models to assess 30-day readmissions as a function of these pollutants, adjusted for patient and hospital characteristics and ambient temperature. Analyses were then stratified by treating hospital performance on the Centers for Medicare and Medicaid Services risk-standardized 30-day poststroke all-cause readmission measure to determine if the results were independent of performance: low (Centers for Medicare and Medicaid Services rate for hospital <25th percentile of national rate), high (>75th percentile), and intermediate (all others). Results: Of 448 148 patients with stroke, 12.5% were readmitted within 30 days. Except for tropospheric NO 2 (no national standard), average 2-year CO, O 3 , particulate matter 2.5, and SO 2 values were below national limits. Each one SD increase in average annual CO, NO 2 , particulate matter 2.5, and SO 2 exposure was associated with an adjusted 1.1% (95% CI, 0.4–1.9%), 3.6% (95% CI, 2.9%–4.4%), 1.2% (95% CI, 0.2%–2.3%), and 2.0% (95% CI, 1.1%–3.0%) increased risk of 30-day readmission, respectively, and O 3 with a 0.7% (95% CI, 0.0%–1.5%) decrease. Associations between long-term air pollutant exposure and increased readmissions persisted across hospital performance categories. Conclusions: Long-term air pollutant exposure below national limits was associated with increased 30-day readmissions after stroke, regardless of hospital performance category. Whether air quality improvements lead to reductions in poststroke readmissions requires further research.","journal":"Stroke","year":2023,"id":345612,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9521,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":106837,"name":"Joshua L. Warren","orcid":"0000-0002-6274-6970","position":1,"is_corresponding":false},{"id":1085585,"name":"Erica C Leifheit","orcid":"0000-0001-9675-8913","position":2,"is_corresponding":false},{"id":439644,"name":"Larry B. Goldstein","orcid":"0000-0001-7747-128X","position":3,"is_corresponding":false},{"id":31023,"name":"Judith H. Lichtman","orcid":"0000-0001-5362-3875","position":4,"is_corresponding":false},{"id":1085584,"name":"Phoebe Tran","orcid":"0000-0003-1735-6903","position":0,"is_corresponding":true}],"reference_count":12,"raw_metadata":null,"created_at":"2026-07-19T01:11:44.152490Z","pmid":"36729388","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}