非动脉炎性前部缺血性视神经病变后中风的风险。

Risk of Stroke After Nonarteritic Anterior Ischemic Optic Neuropathy.

机构信息

Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.

出版信息

Am J Ophthalmol. 2019 Apr;200:123-129. doi: 10.1016/j.ajo.2018.12.022. Epub 2019 Jan 8.

DOI:10.1016/j.ajo.2018.12.022

PMID:30633893

Abstract

PURPOSE

To determine whether nonarteritic ischemic optic neuropathy (NAION) raises the risk of subsequent stroke in the general population.

DESIGN

Population-based, retrospective cohort study.

METHODS

Setting: Nationwide, population-based, retrospective cohort study.

PATIENTS

Of 1 025 340 beneficiaries in the National Health Insurance Service-National Sample Cohort database (2002-2013), we included 400 952 eligible individuals in the analysis.

OBSERVATIONS

To determine the effect of incident NAION on the occurrence of subsequent stroke, we used time-varying covariate Cox regression models. Model 1 included only incident NAION as a time-varying covariate. Model 2 included Model 1 and defined demographics. Model 3 included Model 2, comorbidity, co-medication, and Charlson index score.

MAIN OUTCOME MEASURES

Effect (hazard ratio [HR]) of NAION on stroke development.

RESULTS

Of 400 952 eligible individuals, 1125 patients developed NAION and 16 998 patients suffered from stroke. NAION was not associated with an increased risk of subsequent stroke in Model 1, with HR of 1.31 (95% confidence interval [CI], 0.89-1.92). This was consistent, after adjusting for demographics and/or confounding factors, in Model 2 (HR = 1.19, 95% CI, 0.81-1.75) and Model 3 (HR = 1.10, 95% CI, 0.75-1.62).

CONCLUSIONS

Our results suggest that NAION per se is not associated with a subsequent risk of stroke in the general population.

摘要

目的

确定非动脉炎性缺血性视神经病变（NAION）是否会增加普通人群发生后续卒中的风险。

设计

基于人群的回顾性队列研究。

方法

研究地点：全国范围内的基于人群的回顾性队列研究。

患者

在国家健康保险服务-全国抽样队列数据库（2002-2013 年）中，我们纳入了 1025340 名受益人的 400952 名符合条件的个体进行分析。

观察

为了确定新发 NAION 对后续卒中发生的影响，我们使用了时变协变量 Cox 回归模型。模型 1 仅将新发 NAION 作为时变协变量纳入。模型 2 包括模型 1 并定义了人口统计学特征。模型 3 包括模型 2、合并症、共同用药和 Charlson 指数评分。

主要观察指标

NAION 对卒中发展的影响（危险比 [HR]）。

结果

在 400952 名符合条件的个体中，有 1125 名患者发生了 NAION，有 16998 名患者发生了卒中。在模型 1 中，NAION 与后续卒中风险增加无关，HR 为 1.31（95%置信区间 [CI]，0.89-1.92）。在调整了人口统计学特征和/或混杂因素后，在模型 2（HR=1.19，95%CI，0.81-1.75）和模型 3（HR=1.10，95%CI，0.75-1.62）中结果一致。