Department of Ophthalmology & Visual Science, Yale School of Medicine, New Haven, Connecticut, USA; West Virginia University School of Medicine, Morgantown, West Virginia, USA.
West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Am J Ophthalmol. 2019 Apr;200:179-186. doi: 10.1016/j.ajo.2019.01.009. Epub 2019 Jan 26.
Central retinal artery occlusion (CRAO) confers a high risk of acute vascular ischemic events, including stroke and myocardial infarction (MI). Understanding the burden and risk factor profile of these ischemic events can serve as a valuable guide for ophthalmologists in the management and appropriate referral of these patients.
Retrospective cross-sectional study.
The Nationwide Inpatient Sample (NIS) was queried to identify all inpatient admissions with a diagnosis of CRAO in the United States between the years 2003 and 2014. The primary outcome measure was the incidence of in-hospital acute vascular ischemic events.
There were an estimated 17 117 CRAO inpatient admissions. The mean age was 68.4 ± 0.1 years and 53% of patients were female. The incidence of in-hospital stroke and acute MI were 12.9% and 3.7%. The incidence of stroke showed an increasing trend over the years, almost doubling in 2014 in comparison to 2003 (15.3% vs 7.7%). The combined risk of in-hospital stroke, transient ischemic attack, acute MI, or mortality was 19%. Female sex, hypertension, carotid artery stenosis, aortic valve disease, smoking, and alcohol dependence or abuse were positive predictors of in-hospital stroke.
There is a significant burden of vascular risk factors, associated with an increased risk of in-hospital stroke, acute MI, and death in CRAO patients. The risk of CRAO-associated stroke is highest in women and in those with a history of hypertension, carotid artery stenosis, aortic valve disease, smoking, or alcohol abuse.
视网膜中央动脉阻塞（CRAO）会增加急性血管缺血性事件的风险，包括中风和心肌梗死（MI）。了解这些缺血性事件的负担和风险因素特征，可以为眼科医生管理和适当转介这些患者提供有价值的指导。
回顾性横断面研究。
在美国，通过全国住院患者样本（NIS）查询 2003 年至 2014 年期间所有患有 CRAO 的住院患者入院记录。主要观察指标为住院期间急性血管缺血性事件的发生率。
共纳入 17117 例 CRAO 住院患者。平均年龄为 68.4±0.1 岁，53%为女性。住院期间中风和急性 MI 的发生率分别为 12.9%和 3.7%。中风的发生率呈逐年上升趋势，与 2003 年相比，2014 年几乎翻了一番（15.3%比 7.7%）。住院期间中风、短暂性脑缺血发作、急性 MI 或死亡的综合风险为 19%。女性、高血压、颈动脉狭窄、主动脉瓣疾病、吸烟以及酒精依赖或滥用是住院期间中风的阳性预测因素。
CRAO 患者存在显著的血管危险因素负担，与住院期间中风、急性 MI 和死亡风险增加相关。女性和有高血压、颈动脉狭窄、主动脉瓣疾病、吸烟或酒精滥用史的 CRAO 患者发生 CRAO 相关中风的风险最高。
