Kim Sarasa T, Cloft Harry, Flemming Kelly D, Kallmes David F, Lanzino Giuseppe, Brinjikji Waleed
School of Medicine, Mayo Clinic, Rochester, Minnesota.
Department of Radiology, Mayo Clinic, Rochester, Minnesota.
J Stroke Cerebrovasc Dis. 2017 Aug;26(8):1678-1682. doi: 10.1016/j.jstrokecerebrovasdis.2017.03.025. Epub 2017 Jun 21.
Small studies have suggested that Ehlers-Danlos syndrome (EDS) is associated with a number of cerebrovascular complications. We sought to determine whether a clinical diagnosis of EDS is associated with a higher prevalence of cerebrovascular diseases than the general population by performing a case-control study of hospitalized patients in the Nationwide Inpatient Sample (NIS).
Using the 2000-2012 NIS, we performed a case-control study matching cases of EDS to controls without such a diagnosis. The prevalence of various cerebrovascular diseases between the 2 groups was compared, and multivariate logistic regression was used to adjust for suspected comorbidities.
Between 2000 and 2012, there were a total of 9067 discharges carrying a diagnosis of EDS. On univariate analysis, patients with EDS were more likely to be hospitalized for carotid dissection (.2% versus .01%, odds ratio [OR] = 18.0, confidence interval [CI] = 2.41-135.12, P < .0001), vertebral dissection (.1% versus 0%, P = .008), cervical artery aneurysm (.1% versus .01%, OR = 9.01, CI = 1.14-71.11, P < .0001), cerebral aneurysm (.4% versus .09%, OR = 4.89, CI = 2.28-10.47, P < .0001), and cerebrovascular malformation (.1% versus .02%, OR = 5, CI = 1.10-22.85, P = .021), compared to the controls. On multivariate analysis adjusted for age, race, and comorbidities, EDS patients had significantly higher odds of carotid dissection (OR = 15.02, CI = 3.08-270.87, P < .0001), vertebral dissection (OR = 2406539.5, P = .0037), cervical artery aneurysm (OR = 11.75, CI = 2.11-220.71, P = .0026), cerebral aneurysm (OR = 5.59, CI = 2.69-13.18, P < .0001), and cerebrovascular malformation (OR = 4.67, CI = 1.20-30.87, P = .0243).
Carotid and vertebral dissections, cervical and cerebral aneurysms, as well as other cerebrovascular malformations are more common in hospitalized patients with EDS compared to controls.
小型研究表明，埃勒斯-当洛综合征（EDS）与多种脑血管并发症相关。我们通过对全国住院患者样本（NIS）中的住院患者进行病例对照研究，以确定EDS的临床诊断是否比普通人群具有更高的脑血管疾病患病率。
利用2000 - 2012年的NIS，我们进行了一项病例对照研究，将EDS病例与未诊断出该病的对照进行匹配。比较了两组之间各种脑血管疾病的患病率，并使用多因素逻辑回归来调整可疑的合并症。
2000年至2012年期间，共有9067例出院诊断为EDS。单因素分析显示，与对照组相比，EDS患者因颈动脉夹层住院的可能性更高（0.2%对0.01%，优势比[OR]=18.0，置信区间[CI]=2.41 - 135.12，P<.0001）、椎动脉夹层（0.1%对0%，P=.008）、颈动脉瘤（0.1%对0.01%，OR=9.01，CI=1.14 - 71.11，P<.0001）、脑动脉瘤（0.4%对0.09%，OR=4.89，CI=2.28 - 10.47，P<.0001）以及脑血管畸形（0.1%对0.02%，OR=5，CI=1.10 - 22.85，P=.021）。在对年龄、种族和合并症进行多因素分析调整后，EDS患者发生颈动脉夹层的几率显著更高（OR=15.02，CI=3.08 - 270.87，P<.0001）、椎动脉夹层（OR=2406539.5，P=.0037）、颈动脉瘤（OR=11.75，CI=2.11 - 220.71，P=.0026）、脑动脉瘤（OR=5.59，CI=2.69 - 13.18，P<.0001）以及脑血管畸形（OR=4.67，CI=1.20 - 30.87，P=.0243）。
与对照组相比，颈动脉和椎动脉夹层、颈动脉瘤和脑动脉瘤以及其他脑血管畸形在住院的EDS患者中更为常见。
