Harnod Dorji, Harnod Tomor, Lin Cheng-Li, Hsu Chung Y, Kao Chia-Hung
Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City.
School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City.
Ann Transl Med. 2020 Apr;8(7):471. doi: 10.21037/atm.2020.03.90.
To determine whether poststroke Parkinsonism (PSP) increases mortality risk in poststroke patients by using Taiwan National Health Insurance Research Database (NHIRD).
We analyzed NHIRD data of ≥40-year-old patients diagnosed as having stroke [International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes 430-438] between 2000 and 2013. Poststroke patients were divided into those with subsequent PSP (ICD-9-CM codes 332, 332.0, and 332.1) and without PSP (non-Parkinsonism, PSN) cohorts, all compared with a sex-, age-, comorbidity-, and index date-matched comparison cohort. We calculated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of all-cause mortality risk in these cohorts after adjustments for age, sex, and comorbidities.
PSP was noted in 11.87% (1,644/13,846) of poststroke patients. In the PSN, PSP, and comparison cohorts, mortality incidence rates were 69.1, 124.9, and 38.8 per 1,000 person-years, respectively. Compared with the comparison cohort, the mortality risks in patients aged 40 to 64, 65 to 74, and ≥75 years were respectively 2.21-, 1.91-, and 1.86-fold higher mortality risks in the PSN cohort and 4.57-, 2.84-, and 2.27-fold higher mortality risks in the PSP cohort. Male sex further increased mortality risk in poststroke patients with PSP.
Long-term all-cause mortality risk is increased by 1.39 times in poststroke patients with PSP than in those without. Our findings depict vital information in incidence and risk of PSP. Those would aid clinicians and the government to improve future poststroke care.
利用台湾国民健康保险研究数据库（NHIRD）确定卒中后帕金森综合征（PSP）是否会增加卒中后患者的死亡风险。
我们分析了2000年至2013年间被诊断为患有卒中[国际疾病分类第九版临床修订本（ICD-9-CM）编码430 - 438]的40岁及以上患者的NHIRD数据。卒中后患者被分为随后发生PSP（ICD-9-CM编码332、332.0和332.1）和未发生PSP（非帕金森综合征，PSN）两组，所有患者均与性别、年龄、合并症和索引日期匹配的对照队列进行比较。在对年龄、性别和合并症进行调整后，我们计算了这些队列中全因死亡风险的调整后风险比（aHRs）和95%置信区间（CIs）。
11.87%（1644/13846）的卒中后患者出现PSP。在PSN、PSP和对照队列中，每1000人年的死亡率分别为69.1、124.9和38.8。与对照队列相比，40至64岁、65至74岁和≥75岁患者的死亡风险在PSN队列中分别高出2.21倍、1.91倍和1.86倍，在PSP队列中分别高出4.57倍、2.84倍和2.27倍。男性进一步增加了卒中后PSP患者的死亡风险。
卒中后PSP患者的长期全因死亡风险比未患PSP的患者增加了1.39倍。我们的研究结果描绘了PSP的发病率和风险的重要信息。这些将有助于临床医生和政府改善未来的卒中后护理。
