Medical University of South Carolina, College of Pharmacy, Charleston, SC, USA.
Int J Stroke. 2019 Jan;14(1):48-52. doi: 10.1177/1747493018778135. Epub 2018 May 15.
The impact of cancer on outcomes was not assessed in major trials of systemic thrombolysis in acute ischemic stroke.
To evaluate the association between comorbid cancer and hospital outcomes among patients receiving systemic thrombolysis for the treatment of acute ischemic stroke.
The 2013 and 2014 United States National Inpatient Sample was used to identify adult patients hospitalized for acute ischemic stroke who received systemic thrombolysis. Identified admissions were stratified into two cohorts based on the presence or absence of comorbid cancer. Multivariable logistic regression was performed to determine the association between comorbid cancer and the odds of in-hospital mortality and intracerebral hemorrhage after adjustment for age ≥75 years and comorbid atrial fibrillation.
A total of 13,993 acute ischemic stroke admissions were treated with systemic thrombolysis. Of these, 3.0% ( n = 416) had comorbid cancer. The overall incidence of in-hospital mortality was 7.0% and intracerebral hemorrhage occurred in 7.6% of patients. Upon multivariable adjustment, comorbid cancer was not associated with an increased odds of in-hospital mortality (odds ratio = 1.24; 95% confidence interval = 0.88-1.76). However, the adjusted odds of intracerebral hemorrhage were higher among those with comorbid cancer (odds ratio = 1.60; 95% confidence interval = 1.17-2.17).
In this retrospective study of admissions for acute ischemic stroke receiving thrombolysis, comorbid cancer was not associated with a higher odds of in-hospital mortality but was associated with an increased odds of intracerebral hemorrhage. Factors driving this observed association should be explored in data sets containing clinical variables.
在急性缺血性脑卒中全身性溶栓治疗的主要试验中，并未评估癌症对结局的影响。
评估合并癌症与接受急性缺血性脑卒中全身性溶栓治疗的患者住院结局之间的关系。
使用 2013 年和 2014 年美国国家住院患者样本，确定接受全身性溶栓治疗的急性缺血性脑卒中住院成年患者。根据是否合并癌症，将确定的入院患者分为两组。多变量逻辑回归用于确定合并癌症与住院死亡率和颅内出血的比值比之间的关系，校正年龄≥75 岁和合并心房颤动。
共有 13993 例急性缺血性脑卒中患者接受全身性溶栓治疗。其中 3.0%（n=416）合并癌症。总的住院死亡率为 7.0%，颅内出血发生率为 7.6%。经多变量校正后，合并癌症与住院死亡率增加无关（比值比=1.24；95%置信区间=0.88-1.76）。然而，合并癌症患者颅内出血的调整后比值比更高（比值比=1.60；95%置信区间=1.17-2.17）。
在这项接受溶栓治疗的急性缺血性脑卒中入院患者的回顾性研究中，合并癌症与更高的住院死亡率无关，但与颅内出血的更高比值比相关。应在包含临床变量的数据集中探讨导致这种观察到的相关性的因素。
