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慢性鼻-鼻窦炎增加中风风险:一项 5 年随访研究。

Chronic rhinosinusitis increased the risk of stroke: a 5-year follow-up study.

机构信息

Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan.

出版信息

Laryngoscope. 2013 Apr;123(4):835-40. doi: 10.1002/lary.23829. Epub 2013 Feb 1.

Abstract

OBJECTIVES/HYPOTHESIS: It has been recognized that chronic rhinosinusitis (CRS) involves intracranial vessels and may be associated with stroke occurrence. However, the detailed epidemiological profile of stroke risk among patients with CRS is still not well understood. Therefore, this study aimed to explore the frequency and risk for stroke among patients with CRS by conducting a large scale population-based cohort study in Taiwan.

METHODS

All study cohorts were retrieved from the Taiwan Longitudinal Health Insurance Database. This study included 15,846 CRS subjects in the study cohort and 47,538 randomly selected subjects in the comparison cohort. We individually tracked each subject in this study for a 5 year period following their index dates to identify each subject that received a subsequent diagnosis of stroke. Stratified Cox proportional hazards regressions were analyzed to compare the 5 year risk of subsequent stroke following a diagnosis of CRS.

RESULTS

The incidence rate of stroke during the 5-year follow-up period was 10.65 (95% CI: 9.93-11.41) per 100 person years and 7.53 (95% CI: 7.18-7.89) per 100 person years for the study and comparison cohort, respectively. The covariate-adjusted hazard ratio (HR) for stroke revealed that that subjects with CRS were more likely than comparison subjects to have a diagnosis of ischemic stroke during the 5-year follow-up period (HR = 1.34, 95% CI = 1.18-1.53). However, there was no significant difference in the risk of subarachnoid hemorrhage (HR = 1.52, 95% CI = 0.94-2.47) or intracerebral hemorrhage (HR = 0.96, 95% CI = 0.71-1.31).

CONCLUSIONS

Patients with CRS were at higher risk for stroke occurrence during the 5 year follow-up.

摘要

目的/假设:已经认识到慢性鼻-鼻窦炎(CRS)涉及颅内血管,并且可能与中风的发生有关。然而,CRS 患者中风风险的详细流行病学特征仍不清楚。因此,本研究旨在通过在台湾进行大规模的基于人群的队列研究,探讨 CRS 患者中风的频率和风险。

方法

所有研究队列均从台湾纵向健康保险数据库中检索。本研究包括研究队列中的 15846 例 CRS 患者和 47538 例随机选择的对照队列患者。我们在本研究中对每个患者进行了为期 5 年的个体跟踪,以确定每个患者是否在索引日期后被诊断为中风。使用分层 Cox 比例风险回归分析比较了 CRS 诊断后 5 年内随后发生中风的风险。

结果

在 5 年的随访期间,研究队列和对照队列的中风发生率分别为 10.65(95%CI:9.93-11.41)/100 人年和 7.53(95%CI:7.18-7.89)/100 人年。调整协变量后的中风风险比(HR)表明,与对照队列相比,CRS 患者在 5 年随访期间更有可能被诊断为缺血性中风(HR=1.34,95%CI=1.18-1.53)。然而,蛛网膜下腔出血(HR=1.52,95%CI=0.94-2.47)或脑内出血(HR=0.96,95%CI=0.71-1.31)的风险无显著差异。

结论

在 5 年的随访期间,CRS 患者发生中风的风险较高。

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