Cumming K, Tiamkao S, Kongbunkiat K, Clark A B, Bettencourt-Silva J H, Sawanyawisuth K, Kasemsap N, Mamas M A, Seeley J A, Myint P K
Epidemiology Group,Institute of Applied Health Sciences,School of Medicine,Medical Sciences & Nutrition,University of Aberdeen,Aberdeen,UK.
Neurology Division, Department of Medicine,Faculty of Medicine,Khon Kaen University,Khon Kaen,Thailand.
Epidemiol Infect. 2017 Apr;145(6):1285-1291. doi: 10.1017/S095026881600340X. Epub 2017 Jan 31.
The co-existence of stroke and HIV has increased in recent years, but the impact of HIV on post-stroke outcomes is poorly understood. We examined the impact of HIV on inpatient mortality, length of acute hospital stay and complications (pneumonia, respiratory failure, sepsis and convulsions), in hospitalized strokes in Thailand. All hospitalized strokes between 1 October 2004 and 31 January 2013 were included. Data were obtained from a National Insurance Database. Characteristics and outcomes for non-HIV and HIV patients were compared and multivariate logistic and linear regression models were constructed to assess the above outcomes. Of 610 688 patients (mean age 63·4 years, 45·4% female), 0·14% (866) had HIV infection. HIV patients were younger, a higher proportion were male and had higher prevalence of anaemia (P < 0·001) compared to non-HIV patients. Traditional cardiovascular risk factors, hypertension and diabetes, were more common in the non-HIV group (P < 0·001). After adjusting for age, sex, stroke type and co-morbidities, HIV infection was significantly associated with higher odds of sepsis [odds ratio (OR) 1·75, 95% confidence interval (CI) 1·29-2·4], and inpatient mortality (OR 2·15, 95% CI 1·8-2·56) compared to patients without HIV infection. The latter did not attenuate after controlling for complications (OR 2·20, 95% CI 1·83-2·64). HIV infection is associated with increased odds of sepsis and inpatient mortality after acute stroke.
近年来，中风与艾滋病毒共存的情况有所增加，但艾滋病毒对中风后结局的影响却知之甚少。我们研究了艾滋病毒对泰国住院中风患者的住院死亡率、急性住院时间和并发症（肺炎、呼吸衰竭、败血症和惊厥）的影响。纳入了2004年10月1日至2013年1月31日期间所有住院的中风患者。数据来自国家保险数据库。比较了非艾滋病毒患者和艾滋病毒患者的特征及结局，并构建了多变量逻辑回归和线性回归模型来评估上述结局。在610688名患者（平均年龄63.4岁，45.4%为女性）中，0.14%（866名）感染了艾滋病毒。与非艾滋病毒患者相比，艾滋病毒患者更年轻，男性比例更高，贫血患病率更高（P<0.001）。传统心血管危险因素、高血压和糖尿病在非艾滋病毒组中更为常见（P<0.001）。在调整年龄、性别、中风类型和合并症后，与未感染艾滋病毒的患者相比，艾滋病毒感染与败血症的较高几率[比值比（OR）1.75，95%置信区间（CI）1.29-2.4]和住院死亡率（OR 2.15，95%CI 1.8-2.56）显著相关。在控制并发症后，后者并未减弱（OR 2.20，95%CI 1.83-2.64）。艾滋病毒感染与急性中风后败血症几率和住院死亡率增加相关。
