Increased risk of ischemic stroke in patients with mild traumatic brain injury: a nationwide cohort study

Lee, Yi-Kung; Lee, Chen-Wen; Huang, Ming-Yuan; Hsu, Chin-Hsien; Su, Yung-Cheng

doi:10.1186/s13049-014-0066-y

Cited by 26 publications

(53 citation statements)

References 29 publications

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“…Other studies following these two have further exposed the association between stroke patients and previous TBI [25]. One study focused on the relationship between ischemic stroke and mild TBI and revealed mild TBI as a strong risk factor for ischemic stroke [26]. …”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study

Liu

Huang

Chung

et al. 2017

IJERPH

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Long-term morbidities can develop after traumatic brain injury (TBI). Some studies have suggested that the risk of stroke is higher after TBI, but the association between concussion and stroke remains unclear. Using a national cohort, the authors analyzed the incidence of both hemorrhagic and ischemic strokes in patients with previous concussion. A representative cohort of approximately one million people was followed up for four years. Patients with new-onset concussion were identified (n = 13,652) as the concussion group. Subsequently, the incidence rates of later stroke events in the concussion group were compared to a sex-, age- and propensity score–matched comparison group (n = 13,652). The overall incidence rate of stroke in the concussion group was higher than that of the comparison group (9.63 versus 6.52 per 1000 person-years, p < 0.001). Significantly higher stroke risk was observed in the concussion group than in the comparison group (crude hazard ratio 1.48, p < 0.001; adjusted HR 1.65, p < 0.001). In the concussion group, the cumulative incidence rates of both ischemic stroke and hemorrhagic stroke were higher than those of the comparison group (8.9% vs. 5.8% and 2.7% vs. 1.6%, respectively, both p < 0.001). Concussion is an independent risk factor for both ischemic and hemorrhagic strokes. Prevention and monitoring strategies of stroke are therefore suggested for patients who have experienced concussion.

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Section: Discussionmentioning

confidence: 99%

Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study

Liu

Huang

Chung

et al. 2017

IJERPH

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“… 18 , 19 The database contains comprehensive information on all insured individuals, including gender, date of birth, residential location, dates of clinical visits, the International Classification of Diseases (Ninth Revision) Clinical Modification (ICD-9-CM) diagnostic codes, details regarding prescribed medications, and outcomes at hospital discharge. 20 , 21 …”

Section: Methodsmentioning

confidence: 99%

Bidirectional Relationship Between Diabetes and Acute Pancreatitis

et al. 2016

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The proposed bidirectional relationship between acute pancreatitis (AP) and diabetes has never been examined with the same source of data. Furthermore, the effects of disease severity on this relationship have not been fully evaluated. The present study employed the findings from a single database to measure the strength of the association between AP and diabetes.Findings from 1 million National Health Insurance beneficiaries were utilized. Two cohort studies with this database were selected to evaluate the linkage between diabetes and AP. The first cohort analysis addressed the risk of AP among diabetic patients and was comprised of 42,080 diabetic patients and 672,146 unexposed subjects. The second cohort analysis considered the risk of diabetes among patients with AP and enrolled 3187 patients with AP and 709259 unexposed subjects. All adult beneficiaries were followed from January 1, 2005 to December 31, 2012 to identify outcomes of interest. Cox regression models were applied to compare hazards adjusted for potential confounders.For the first cohort, the adjusted hazard ratio (HR) of AP was significantly increased by the presence of diabetes (1.72; 95% confidence interval [CI], 1.52–1.96). In diabetic patients with a history of hyperglycemic crisis episodes (HCEs), the HR was even higher (6.32; 95% CI, 4.54–8.81). For the second cohort, the adjusted HR of diabetes in patients with AP was increased compared to the general population (2.15; 95% CI, 1.92–2.41). For patients with severe AP, the HR was also higher (2.22; 95% CI, 1.50–3.29) but did not differ significantly from that for patients with nonsevere AP.The 2 cohort studies provided evidence for the bidirectional relationship between diabetes and AP. Moreover, diabetic patients with history of HCEs may be associated with higher risk of AP.

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“…The detailed ICD-9-CM codes for comorbidities are described elsewhere, and the processes used for selecting comorbidities are standard and widely accepted [19,21,22]. …”

Section: Methodsmentioning

confidence: 99%

Association between Chronic Kidney Disease and Risk of Cataract: A Nationwide Retrospective Cohort Study

Liu

Hung²,

Lee³

et al. 2017

Am J Nephrol

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Background: Previous studies have established a relationship between chronic kidney disease (CKD) and cataract, but the relationship between the severity of renal impairment and risk of cataract is uncertain. This study investigates the relationship between the severity of renal disease and cataract in a nationwide sample from Taiwan. Methods: The cohort from 1-million National Health Insurance beneficiaries from Taiwan was retrospectively analyzed. All adult beneficiaries were followed from January 1, 2005 until December 31, 2013, to identify patients who underwent cataract surgeries. On the basis of the ambulatory care records, those diagnosed with CKD (ICD-9-CM code: 585) during the follow-up period were enrolled as CKD patients after careful evaluation. Each patient with CKD was age- and gender-matched with 4 individuals who did not have CKD. Cox regression models were applied to compare the hazard of cataract surgery in individuals with and without CKD. Subgroup analysis was used to compare patients with end-stage renal disease (ESRD) with age- and gender-matched non-CKD individuals. ESRD was defined by CKD patients who need regular renal replacement therapy. The same method was applied to evaluate hazard ratios (HRs). Results: After age and gender matching, there were 11,881 patients in the CKD group and 47,524 in the non-CKD group. After control for possible confounding, the adjusted HR (aHR) of cataract was 1.84 (95% CI 1.73-1.95) for the CKD group. Subgroup analysis of patients with ESRD (n = 3,209) and non-CKD individuals (n = 12,836), with matching done on the basis of age and gender, indicated an aHR of cataract was 2.33 (95% CI 2.10-2.59) for the ESRD group. Conclusions: This study indicates a relationship between CKD and cataract, and suggests that the risk for cataract increases with the severity of renal impairment.

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Increased risk of ischemic stroke in patients with mild traumatic brain injury: a nationwide cohort study

Cited by 26 publications

References 29 publications

Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study

Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study

Bidirectional Relationship Between Diabetes and Acute Pancreatitis

Association between Chronic Kidney Disease and Risk of Cataract: A Nationwide Retrospective Cohort Study

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