Department of Radiology (Li), E-Da Hospital; Department of Radiology (Huang), Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan; Management Office for Health Data (Su) and Department of Nuclear Medicine and PET Center (Kao), China Medical University Hospital; College of Medicine (Su) and Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine (Kao), China Medical University; Department of Bioinformatics and Medical Engineering (Kao), Asia University, Taichung, Taiwan.
Department of Radiology (Li), E-Da Hospital; Department of Radiology (Huang), Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan; Management Office for Health Data (Su) and Department of Nuclear Medicine and PET Center (Kao), China Medical University Hospital; College of Medicine (Su) and Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine (Kao), China Medical University; Department of Bioinformatics and Medical Engineering (Kao), Asia University, Taichung, Taiwan
CMAJ. 2018 Mar 12;190(10):E285-E290. doi: 10.1503/cmaj.170994.
Stroke is a severe neurologic complication of dengue fever, described in only a few case reports. The incidence and risk factors for stroke in patients with dengue remain unclear. We conducted a population-based retrospective cohort study to investigate the risk of stroke in patients with dengue.
Using data from the Taiwan National Health Insurance Research Database, we included a total of 13 787 patients with dengue newly diagnosed between 2000 and 2012. The control cohort consisted of patients who did not have dengue, matched 1:1 by demographic characteristics and stroke-related comorbidities. We calculated the cumulative incidences and hazard ratios (HRs) of stroke in both cohorts using Kaplan-Meier curves and Cox proportional hazards regression.
The overall incidence rate of stroke was 5.33 per 1000 person-years in the dengue cohort and 3.72 per 1000 person-years in the control cohort, with an adjusted HR of 1.16 (95% confidence interval [CI] 1.01-1.32). The risk of stroke among patients with dengue was highest in the first 2 months after diagnosis (25.53 per 1000 person-years, adjusted HR 2.49, 95% CI 1.48-4.18).
Dengue fever was associated with an increased risk of stroke in the first few months after diagnosis. The effect of dengue on stroke may be acute rather than chronic.
中风是登革热的一种严重神经并发症，仅在少数病例报告中有所描述。登革热患者中风的发病率和危险因素仍不清楚。我们进行了一项基于人群的回顾性队列研究，以调查登革热患者中风的风险。
利用来自台湾全民健康保险研究数据库的数据，我们共纳入了 2000 年至 2012 年间新诊断为登革热的 13787 名患者。对照组由未患登革热的患者组成，按照人口统计学特征和中风相关合并症进行 1:1 匹配。我们使用 Kaplan-Meier 曲线和 Cox 比例风险回归计算了两个队列中中风的累积发生率和风险比（HR）。
登革热组中风的总发病率为 5.33/1000 人年，对照组为 3.72/1000 人年，调整后的 HR 为 1.16（95%置信区间[CI]1.01-1.32）。登革热患者中风的风险在诊断后前 2 个月最高（25.53/1000 人年，调整后的 HR 2.49，95%CI 1.48-4.18）。
登革热与诊断后几个月中风风险增加有关。登革热对中风的影响可能是急性的而不是慢性的。
