De Stefano Frank, Mayo Timothy, Covarrubias Claudia, Fiani Brian, Musch Brian
College of Osteopathic Medicine, Kansas City University, Kansas City, Missouri, United States.
School of Medicine, Universidad Anáhauc Querétaro, Santiago de Querétaro, Mexico.
Surg Neurol Int. 2021 Jun 7;12:268. doi: 10.25259/SNI_415_2021. eCollection 2021.
Stroke risk has been attributed to many pathological and behavioral conditions. Various modifiable and non-modifiable risk factors have been recognized and found consistent throughout epidemiological studies. Herein, we investigate the effect of comorbidities seen with patient's suffering from ischemic stroke and its effect on in-hospital mortality.
We identified patients >18 year old in the National Inpatient Sample database with diseases of interest utilizing the tenth International Classification of Disease 10 diagnostic codes from the years 2016 to 2018. Interval data were analyzed using one-way ANOVA. analysis was performed using Bonferroni correction methods. To determine independent predictors of in-hospital mortality, odds ratios were calculated using binary logistic regression for each comorbidity. Descriptive and numerical statistics, imputation, and logistic regression were calculated using SPSS software version 25.
Patients hospitalized with ischemic stroke were found to have the following comorbidities: atrial fibrillation (7.5%), carotid artery stenosis (1.1%), diabetes mellitus type 2 (11.4%), congestive heart failure (CHF) (7.5%), essential hypertension (21.2%), and ischemic heart disease (IHD) (2.3%). In-hospital mortality rates were higher in patients hospitalized with ischemic stroke and concomitant IHD (28.2%, < 0.001). Hospital length of stay was longest in patients with concomitant CHF (5.96 days, < 0.001). Similarly, patients with CHF accrued the greatest in-hospital costs (69,174 USD, < 0.001).
Patients hospitalized from ischemic stroke suffered from the coexistence of other comorbidities. Of the comorbidities studied, IHD was identified as having the most significant impact on in-hospital mortality.
中风风险与许多病理和行为状况有关。各种可改变和不可改变的风险因素已得到确认，并且在整个流行病学研究中保持一致。在此，我们调查缺血性中风患者合并症的影响及其对住院死亡率的影响。
我们利用2016年至2018年的第十版国际疾病分类10诊断代码，在国家住院样本数据库中识别出年龄大于18岁且患有相关疾病的患者。区间数据采用单因素方差分析进行分析。采用Bonferroni校正方法进行分析。为了确定住院死亡率的独立预测因素，对每种合并症使用二元逻辑回归计算比值比。使用SPSS软件版本25计算描述性和数值统计、插补和逻辑回归。
发现因缺血性中风住院的患者有以下合并症：心房颤动（7.5%）、颈动脉狭窄（1.1%）、2型糖尿病（11.4%）、充血性心力衰竭（CHF）（7.5%）、原发性高血压（21.2%）和缺血性心脏病（IHD）（2.3%）。因缺血性中风合并IHD住院的患者住院死亡率更高（28.2%，<0.0０1）。合并CHF的患者住院时间最长（5.96天，<0.0０1）。同样，合并CHF的患者住院费用最高（69,174美元，<0.0０1）。
因缺血性中风住院的患者存在其他合并症。在所研究的合并症中，IHD被确定为对住院死亡率影响最大的合并症。
