癌症合并缺血性和出血性脑卒中患者的结局：日本脑卒中数据库。

Outcomes in ischemic and hemorrhagic stroke patients with cancer: The Japan Stroke Data Bank.

机构信息

Department of Neurology, National Cerebral and Cardiovascular Centre, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan.

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Centre, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan.

出版信息

J Neurol Sci. 2024 Nov 15;466:123234. doi: 10.1016/j.jns.2024.123234. Epub 2024 Sep 14.

DOI:10.1016/j.jns.2024.123234

PMID:39288721

Abstract

INTRODUCTION

Data on the impact of malignancy on outcomes in patients with stroke, especially hemorrhagic stroke, are limited. We aimed to clarify the association between cancer and outcomes for each stroke type (ischemic/hemorrhagic) using a hospital-based multicenter stroke registration database.

PATIENTS AND METHODS

Study participants were adult patients within 7 days of the onset of ischemic stroke (IS) or hemorrhagic stroke (HS) between 2000 and 2020 in the Japan Stroke Data Bank (JSDB). The patients were categorized into two groups according to whether they had a history of cancer. Outcomes included good functional outcomes, representing a modified Rankin Scale score of 0-2 at discharge and in-hospital mortality.

RESULTS

Of the 203,983 patients analyzed in this substudy, 152,591 (women, 39.9 %; median age, 75 years) had IS, and 51,392 (48.6 %; 69 years) had HS. Of these, 6409 IS (4.2 %) and 1560 HS (3.0 %) patients had any cancer. IS patients with cancer had a lower frequency of good functional outcomes (47.5 % vs. 56.3 %; adjusted odds ratio [aOR] 0.85, 95 % confidence interval [CI] 0.79-0.91) and a higher incidence of in-hospital mortality (6.7 % vs. 4.5 %; aOR 1.59, 95 % CI 1.41-1.80) than those without cancer. HS patients with cancer showed a lower frequency of good functional outcome (24.9 % vs. 35.7 %; aOR 0.88, 95 % CI 0.78-0.99) and higher incidence of in-hospital mortality (20.1 % vs. 16.0 %; aOR 1.26, 95 % CI 1.04-1.52) than those without cancer.

CONCLUSIONS

Both IS and HS patients with cancer had significantly lower good functional outcomes and more in-hospital mortality.

摘要

介绍

关于恶性肿瘤对卒中患者（尤其是出血性卒中患者）结局的影响的数据有限。我们旨在利用基于医院的多中心卒中登记数据库，阐明癌症与每种卒中类型（缺血性/出血性）之间的关联。

患者和方法

本研究的参与者为 2000 年至 2020 年期间在日本卒中数据库（JSDB）中发病 7 天内的缺血性卒中和出血性卒中患者（年龄均＞18 岁）。根据患者是否有癌症史将其分为两组。结局包括良好的功能结局，定义为出院时和住院期间改良 Rankin 量表评分为 0-2 分，以及住院期间死亡率。

结果

在本亚研究中，对 203983 例患者进行了分析，其中 152591 例（女性占 39.9%；中位年龄 75 岁）为缺血性卒中，51392 例（48.6%；69 岁）为出血性卒中。其中，6409 例（4.2%）缺血性卒中和 1560 例（3.0%）出血性卒中患者患有任何类型的癌症。患有癌症的缺血性卒中患者的良好功能结局发生率较低（47.5% vs. 56.3%；调整后优势比[OR]0.85，95%置信区间[CI]0.79-0.91），住院期间死亡率较高（6.7% vs. 4.5%；OR 1.59，95%CI 1.41-1.80）。患有癌症的出血性卒中患者的良好功能结局发生率较低（24.9% vs. 35.7%；OR 0.88，95%CI 0.78-0.99），住院期间死亡率较高（20.1% vs. 16.0%；OR 1.26，95%CI 1.04-1.52）。