From the Clinical and Translational Neuroscience Unit (Y.B.A., P.P., A.C., S.M., B.B.N., C.Z., H.K., A.E.M.), Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medical College; and Department of Neurology (A.L.L., J.D.), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.
Neurology. 2021 Feb 16;96(7):e1005-e1011. doi: 10.1212/WNL.0000000000011420. Epub 2021 Jan 4.
To test the hypothesis that the prevalence of cervical artery dissection remains constant across age groups, we evaluated the relationship between age and cervical artery dissection in patients with stroke using a nationally representative sample from the United States.
We used inpatient claims data included in the 2012-2015 releases of the National Inpatient Sample (NIS). We used validated ICD-9-CM codes to identify adults hospitalized with ischemic stroke and a concomitant diagnosis of carotid or vertebral artery dissection. Survey weights provided by the NIS and population estimates from the US census were used to calculate nationally representative estimates. The χ test for trend was used to compare the prevalence of concomitant dissection among stroke hospitalizations across patient subgroups defined by age. Poisson regression and the Wald test for trend were used to evaluate whether the prevalence of hospitalizations for stroke and concomitant dissection per million person-years varied by age groups.
There were 17,320 (95% confidence interval [CI], 15,614-19,026) hospitalizations involving ischemic stroke and a concomitant dissection. The prevalence of dissection among stroke hospitalizations decreased across 10-year age groups from 7.2% (95% CI, 6.2%-8.1%) among persons younger than 30 years to 0.2% (95% CI, 0.1%-0.2%) among persons older than 80 years ( value for trend <0.001). However, the prevalence of hospitalizations for stroke and concomitant dissection increased from 5.4 (95% CI, 4.6-6.2) hospitalizations per million person-years among adults younger than 30 to 24.4 (95% CI, 21.0-27.9) hospitalizations per million person-years among adults older than age 80 ( value for trend <0.01).
In a nationally representative sample, the prevalence of hospitalizations for dissection-related stroke increased with age.
为了验证颈内动脉夹层在各年龄段的患病率保持不变的假设，我们使用来自美国的全国代表性样本评估了年龄与中风患者颈内动脉夹层之间的关系。
我们使用了包含在 2012-2015 年国家住院患者样本（NIS）中的住院患者数据。我们使用了经过验证的 ICD-9-CM 代码来识别因缺血性中风和同时伴有颈动脉或椎动脉夹层而住院的成年人。NIS 提供的调查权重和美国人口普查的人口估计用于计算全国代表性估计。使用 χ 趋势检验比较了按年龄划分的中风住院患者中并发夹层的患病率。泊松回归和 Wald 趋势检验用于评估每百万人口年中风和并发夹层的住院人数是否随年龄组而变化。
共有 17320 例（95%置信区间[CI]，15614-19026）涉及缺血性中风和并发夹层的住院治疗。在 10 岁年龄组中，中风住院患者中夹层的患病率从 30 岁以下人群的 7.2%（95%CI，6.2%-8.1%）下降到 80 岁以上人群的 0.2%（95%CI，0.1%-0.2%）（趋势值<0.001）。然而，中风和并发夹层住院的患病率从 30 岁以下成年人每百万人口年 5.4（95%CI，4.6-6.2）住院人数增加到 80 岁以上成年人每百万人口年 24.4（95%CI，21.0-27.9）住院人数（趋势值<0.01）。
在全国代表性样本中，与夹层相关的中风住院率随年龄增长而增加。
