Lin Herng-Ching, Chao Pin-Zhir, Lee Hsin-Chien
Department of Psychiatry, School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
Stroke. 2008 Oct;39(10):2744-8. doi: 10.1161/STROKEAHA.108.519090. Epub 2008 Jun 26.
No previous study has investigated the incidence or risk of cerebrovascular diseases developing after the sudden sensorineural hearing loss (SSNHL). This study sets out to estimate the risk of stroke development among SSNHL patients during a 5e-year follow-up period after hospitalization for acute episodes of SSNHL.
Our study design features a study cohort and a comparison cohort. The study cohort consists of all patients hospitalized with a principal diagnosis of sudden hearing loss (n=1,423), whereas the control cohort comprised all patients hospitalized for an appendectomy in 1998 (n=5692) as a surrogate for the general population. Each patient was tracked from hospitalization in 1998 until the end of 2003. Cox proportional hazard regressions were performed as a means of computing the 5-year stroke-free survival rates after adjustment for possible confounding factors.
Of the total sample, 621 patients (8.7%) had strokes during the 5-year follow-up period: 180 (12.7% of the SSNHL patients) from the study cohort and 441 (7.8% of patients undergoing an appendectomy) from the control cohort. After adjusting for other factors, the hazard of stroke during the 5-year follow-up period was 1.64-times (95% CI, 1.31 to 2.07; P<0.001) greater for SSNHL patients than for appendectomy patients.
Our findings suggest that SSNHL can be an early warning sign of impending stroke. We suggest that SSNHL patients should undergo a comprehensive hematologic and neurological examination to help clinicians identify those potentially at risk for stroke developing in the near future.
此前尚无研究调查过突发性感音神经性听力损失(SSNHL)后发生脑血管疾病的发生率或风险。本研究旨在评估SSNHL患者在因SSNHL急性发作住院后5年随访期内发生中风的风险。
我们的研究设计包括一个研究队列和一个对照队列。研究队列由所有以突发性听力损失为主诊断住院的患者组成(n = 1423),而对照队列由1998年因阑尾切除术住院的所有患者组成(n = 5692),作为一般人群的替代。每位患者从1998年住院开始跟踪至2003年底。进行Cox比例风险回归分析,以计算在调整可能的混杂因素后5年无中风生存率。
在整个样本中,621名患者(8.7%)在5年随访期内发生中风:研究队列中有180名(占SSNHL患者的12.7%),对照队列中有441名(占接受阑尾切除术患者的7.8%)。在调整其他因素后,SSNHL患者在5年随访期内中风的风险比阑尾切除术患者高1.64倍(95%CI,1.31至2.07;P<0.001)。
我们的研究结果表明,SSNHL可能是即将发生中风的早期预警信号。我们建议SSNHL患者应接受全面的血液学和神经学检查,以帮助临床医生识别那些近期有中风潜在风险的患者。