Edigin Ehizogie, Eseaton Precious, Kaul Subuhi, Shaka Hafeez, Ojemolon Pius E, Asemota Iriagbonse R, Akuna Emmanuel, Manadan Augustine
Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.
Internal Medicine, University of Benin, Benin City, NGA.
Cureus. 2020 Jul 12;12(7):e9155. doi: 10.7759/cureus.9155.
Introduction Systemic sclerosis (SSc) is known to increase the risk of ischemic stroke and other cerebrovascular events. It is, however, unclear if SSc negatively impacts the outcomes of ischemic stroke hospitalizations. This study aims to compare the outcomes of patients primarily admitted for ischemic stroke with and without a secondary diagnosis of SSc. Methods Data were extracted from the National Inpatient Sample (NIS) 2016 and 2017 database. NIS is the largest hospitalization database in the United States. We searched the database for hospitalizations of adult patients admitted with a principal diagnosis of ischemic stroke, with and without SSc as the secondary diagnosis using International Classification of Diseases, Tenth Revision (ICD-10) codes. The primary outcome was inpatient mortality, and secondary outcomes were hospital length of stay (LOS), total hospital charge, odds of undergoing mechanical thrombectomy, and receiving tissue plasminogen activator (TPA). Multivariate logistic and linear regression analysis was used to adjust for confounders. Results Over 71 million discharges were included in the NIS database for the years 2016 and 2017. Out of 525,570 hospitalizations for ischemic stroke, 410 (0.08%) had SSc. Hospitalizations for ischemic stroke with SSc had similar inpatient mortality (6.10% vs 5.53%, adjusted OR 0.66, 95% CI (0.20-2.17); p=0.492), length of stay (LOS) (5.9 vs 5.7 days; p=0.583), and total hospital charge ($74,958 vs $70,197; p=0.700) compared to those without SSc. Odds of receiving TPA (9.76% vs 9.29%, AOR 1.08, 95% CI (0.51-2.27), P=0.848) and undergoing mechanical thrombectomy (7.32% vs 5.06%, AOR 0.75, 95% CI (0.28-1.98), P=0.556) was similar between both groups. Conclusions Hospitalizations for ischemic stroke with SSc had similar inpatient mortality, LOS, total hospital charge, odds of receiving TPA, and mechanical thrombectomy compared to those without SSc.
引言 系统性硬化症（SSc）已知会增加缺血性中风和其他脑血管事件的风险。然而，目前尚不清楚SSc是否会对缺血性中风住院治疗的结果产生负面影响。本研究旨在比较主要因缺血性中风入院且有或没有SSc二级诊断的患者的治疗结果。方法 数据从2016年和2017年的国家住院患者样本（NIS）数据库中提取。NIS是美国最大的住院数据库。我们使用国际疾病分类第十版（ICD-10）编码在数据库中搜索以缺血性中风为主诊断入院的成年患者的住院记录，这些患者有或没有SSc作为二级诊断。主要结局是住院死亡率，次要结局包括住院时间（LOS）、总住院费用、接受机械取栓术的几率以及接受组织纤溶酶原激活剂（TPA）的情况。采用多因素逻辑回归和线性回归分析来调整混杂因素。结果 2016年和2017年NIS数据库纳入了超过7100万份出院记录。在525570例缺血性中风住院病例中，410例（0.08%）患有SSc。与没有SSc的缺血性中风住院患者相比，患有SSc的缺血性中风住院患者的住院死亡率（6.10%对5.53%，调整后的OR为0.66，95%CI（0.20 - 2.17）；p = 0.492）、住院时间（LOS）（5.9天对5.7天；p = 0.583）和总住院费用（74958美元对70197美元；p = 0.700）相似。两组接受TPA的几率（9.76%对9.29%，AOR为1.08，95%CI（0.51 - 2.27），P = 0.848）和接受机械取栓术的几率（7.32%对5.06%，AOR为0.75，95%CI（0.28 - 1.98），P = 0.556）相似。结论 与没有SSc的缺血性中风住院患者相比，患有SSc的缺血性中风住院患者在住院死亡率、LOS、总住院费用、接受TPA的几率和机械取栓术方面相似。
