Department of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, DOC-6100; 90 Bergen Street, Newark, NJ 07103, USA.
J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105002. doi: 10.1016/j.jstrokecerebrovasdis.2020.105002. Epub 2020 Jun 15.
Retinal artery occlusion (RAO) can cause acute, painless, and irreversible loss of vision. Using a large sample population database, we investigated the possible impact of RAO and numerous other clinical and non-clinical factors on the risk of developing a subsequent cerebrovascular accident.
Cases of RAO were obtained from the National Inpatient Sample (NIS) database between 2002 and 2013 using ICD-9 codes. Associated morbidities and procedures were assessed in these cases with a primary hospital admitting diagnosis of stroke. Univariate and multivariate logistic regression analyses were carried out in RAO cases to determine risk factors for stroke. The Bonferroni correction method was applied.
The RAO group consisted of 19,809 cases that were separated into stroke (n=1,157, 55% male, mean age: 69±0.4 years) and non-stroke (n=18,652, 55% male, mean age: 68±0.1) cohorts. Age groups associated with reduced risk of stroke with respect to were 20-39 (OR: 0.391), 40-59 (OR: 0.842), and 60-79 (OR: 0.837). No cases of stroke were present for ages < 20. Other factors associated with a reduced stroke risk were carotid stenosis (OR: 0.187), transient ischemic attack (OR: 0.064), coronary artery disease (OR: 0.788), cardiac catheterization (OR: 0.481), and septicemia (OR: 0.333). Factors associated with an increased risk of stroke included hypertension (OR: 1.418), tobacco use (OR: 1.568), valvular disease (OR: 1.359), hyperlipidemia (OR: 1.298), and non-stroke cerebrovascular disease (OR: 2.985).
A large patient population was used to determine that RAO patients with a history of hypertension, hyperlipidemia, tobacco usage, valvular disease, or non-stroke cerebrovascular disease had an increased risk of stroke. Patients below the age of 40 had significantly reduced the odds of stroke. Carotid stenosis, coronary artery disease, transient ischemic attacks, cardiac catheterization, and septicemia were all independently associated with a decreased risk of stroke development in RAO patients.
视网膜动脉阻塞 (RAO) 可导致急性、无痛和不可逆转的视力丧失。本研究使用大型患者人群数据库，调查了 RAO 以及其他许多临床和非临床因素对随后发生脑血管意外的风险的可能影响。
通过国际疾病分类第 9 版 (ICD-9) 代码，从 2002 年至 2013 年的国家住院患者样本 (NIS) 数据库中获取 RAO 病例。通过初次住院诊断为中风的方法评估这些病例的相关合并症和程序。对 RAO 病例进行单变量和多变量逻辑回归分析，以确定中风的危险因素。应用了 Bonferroni 校正法。
RAO 组包括 19809 例病例，分为中风 (n=1157，55%男性，平均年龄：69±0.4 岁) 和非中风 (n=18652，55%男性，平均年龄：68±0.1 岁) 两组。与中风风险降低相关的年龄组分别为 20-39 岁 (OR：0.391)、40-59 岁 (OR：0.842) 和 60-79 岁 (OR：0.837)。20 岁以下的病例中无中风发生。其他与中风风险降低相关的因素包括颈动脉狭窄 (OR：0.187)、短暂性脑缺血发作 (OR：0.064)、冠心病 (OR：0.788)、心导管检查 (OR：0.481) 和败血症 (OR：0.333)。与中风风险增加相关的因素包括高血压 (OR：1.418)、吸烟 (OR：1.568)、瓣膜病 (OR：1.359)、高脂血症 (OR：1.298) 和非中风性脑血管疾病 (OR：2.985)。
本研究使用大量患者人群确定，患有高血压、高脂血症、吸烟、瓣膜病或非中风性脑血管疾病的 RAO 患者发生中风的风险增加。40 岁以下的患者中风的几率显著降低。颈动脉狭窄、冠心病、短暂性脑缺血发作、心导管检查和败血症均与 RAO 患者中风发生率降低独立相关。
