Liu Chi-Chun, Chen Yu-Hsuan, Chang Yin-Han, Chien Wu-Chien, Lin Hui-Chen, Cheng Chun-Gu, Cheng Chun-An
Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
Division of Chest Medicine, Department of Internal Medicine, Cheng Hsin General Hospital, Taipei 11220, Taiwan.
Healthcare (Basel). 2022 Feb 17;10(2):381. doi: 10.3390/healthcare10020381.
Chronic obstructive pulmonary disease (COPD) induces atrial fibrillation (AF) and stroke, and COPD with AF increased ischemic stroke (IS) in a cross-sectional study. Therefore, healthcare providers must be concerned and well-informed about this particular situation. For this study, inpatient data were obtained from the Taiwan National Health Insurance Database in 2010. We identified patients who were hospitalized with COPD (International Classification of Disease, Ninth Revision, Clinical Modification [ICD-9-CM] is 491, 492, and 496). Patients who experienced AF (ICD-9-CM to 427.3) during the same admission or after COPD hospitalization were discharged and defined as new-onset AF. The outcome was IS (ICD-9-CM as 433-437). The factors related to IS after COPD were used for multivariate logistic regression. There were 4177/62,163 (6.72%) patients with incident IS. The risk of IS after COPD hospitalization was shown to have an adjusted odds ratio of 1.749 (95% CI: 1.584-1.93, < 0.001) for patients with new-onset AF. Other factors included advanced age, atherosclerosis factors, comorbidity severity, sepsis and lower-level hospital admission. In conclusion, COPD patients suffering from new-onset AF had an increased incidence of IS in the population observation study. New-onset AF was an omit risk factor for IS in COPD in the Chinese population.
慢性阻塞性肺疾病(COPD)可诱发心房颤动(AF)和中风,一项横断面研究显示,合并AF的COPD患者发生缺血性中风(IS)的风险增加。因此,医疗服务提供者必须关注并充分了解这一特殊情况。本研究使用了2010年台湾国民健康保险数据库中的住院患者数据。我们确定了因COPD住院的患者(国际疾病分类第九版临床修订本[ICD-9-CM]编码为491、492和496)。在同一住院期间或COPD住院后发生AF(ICD-9-CM编码为427.3)的出院患者被定义为新发AF。结局指标为IS(ICD-9-CM编码为433 - 437)。将与COPD后发生IS相关的因素用于多因素logistic回归分析。共有4177/62163(6.72%)例患者发生了IS。对于新发AF患者,COPD住院后发生IS的风险经调整后的比值比为1.749(95%可信区间:1.584 - 1.93,P<0.001)。其他因素包括高龄、动脉粥样硬化因素、合并症严重程度、脓毒症以及较低级别的医院入院。总之,在人群观察研究中患有新发AF的COPD患者发生IS的几率增加。在中国人群中,新发AF是COPD患者发生IS的一个遗漏风险因素。