Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
Atherosclerosis. 2017 Aug;263:29-35. doi: 10.1016/j.atherosclerosis.2017.05.030. Epub 2017 May 25.
BACKGROUND & AIMS: The association between liver cirrhosis (LC) and stroke is not completely understood. Our purpose was to evaluate stroke risk and post-stroke outcomes in patients with LC.
We identified 6944 adults aged 20 years and older, newly diagnosed with LC, using the Taiwan's National Health Insurance Research Database from 2000 to 2005. The comparison cohort consisted of 27,776 adults without LC, randomly selected by frequency matching in age and sex. Events of new-onset stroke were identified from medical claims during the 2000-2013 follow-up period. Adjusted hazard ratios (HR) and 95% confidence intervals (CIs) of stroke associated with LC were calculated in the multiple Cox proportional hazard model. Another nested stroke cohort study of 21,267 hospitalized stroke patients analyzed adjusted odds ratios (ORs) and 95% CIs of adverse events after stroke, among patients with and without LC, between 2000 and 2009.
The incidences of stroke for people with and without LC were 6.1 and 4.3 per 1000 person-years, respectively. Compared with the non-cirrhotic cohort, the adjusted HR of stroke was 1.55 (95% CI 1.28-1.87) for LC patients. Previous LC was associated with risks of epilepsy (OR 1.30, 95% CI 1.09-1.56), admission to intensive care unit (OR 1.23, 95% CI (1.14-1.32) and in-hospital mortality (OR 1.83, 95% CI 1.63-2.05) after stroke.
LC was associated with higher risk of stroke, and patients with LC had more complications and mortality after stroke. This susceptible population needs strategies to prevent stroke and post-stroke adverse events.
肝硬化（LC）与中风之间的关联尚不完全清楚。我们的目的是评估 LC 患者中风风险和中风后结局。
我们使用台湾全民健康保险研究数据库，从 2000 年至 2005 年，识别了 6944 例年龄在 20 岁及以上新诊断为 LC 的成年人。对照队列由 27776 例无 LC 的成年人组成，通过年龄和性别频率匹配随机选择。在 2000-2013 年的随访期间，根据医疗记录确定新发中风事件。在多 Cox 比例风险模型中计算与 LC 相关的中风的调整后的危险比（HR）和 95%置信区间（CI）。在 2000 年至 2009 年期间，另一项嵌套的中风患者队列研究分析了有和无 LC 的住院中风患者的不良事件的调整后的比值比（OR）和 95%CI。
LC 患者和无 LC 患者的中风发生率分别为 6.1 和 4.3/1000 人年。与非肝硬化队列相比，LC 患者的中风调整后 HR 为 1.55（95%CI 1.28-1.87）。既往 LC 与癫痫（OR 1.30，95%CI 1.09-1.56）、入住重症监护病房（OR 1.23，95%CI 1.14-1.32）和住院死亡率（OR 1.83，95%CI 1.63-2.05）相关。
LC 与中风风险增加相关，LC 患者中风后并发症和死亡率更高。这一易感人群需要采取策略预防中风和中风后不良事件。
