Ogunniyi Kayode E, Alagbo Habib Olatunji, Tolu-Akinnawo Oluwaremilekun Zeth, Ibrahim Selimat, Adeleke Oluwaseun Dorcas, Mahtani Arun, Ugwendum Derek Fan, Padda Indebir, Farid Meena, Awoyemi Toluwalase
Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, New York, USA.
Department of Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Int J Hepatol. 2025 Mar 19;2025:9250819. doi: 10.1155/ijh/9250819. eCollection 2025.
Ischemic stroke remains a leading cause of preventable cardiovascular mortality worldwide, with emerging evidence suggesting an association between liver cirrhosis and both stroke occurrence and severity. However, the specific impact of cirrhosis on stroke-related mortality remains incompletely understood. Elucidating this relationship is crucial for improving risk stratification and early recognition of high-risk individuals. : We conducted a retrospective cohort study comparing ischemic stroke patients with cirrhosis to those without, using the National Inpatient Sample database for 2021. Univariate and multivariate logistic regression analyses were performed to compare various outcomes. A total of 536,199 discharges for ischemic stroke were included, among which 4464 had a documented history of liver cirrhosis. Discharges with cirrhosis were predominantly male (58.2%) with a mean age of 67 years, which was 2.17 years younger than those without cirrhosis. In-hospital mortality was 7% (95% CI: 5.5%-8.99%) among discharges with cirrhosis versus 4.2% (95% CI: 4.0%-4.33%) in those without.. After adjusting for cofounders in multivariate logistic regression, it was revealed that cirrhosis is associated with 69% higher mortality risk in stroke discharges (OR = 1.69, 95% CI: 1.27-2.25, < 0.001). Our study identifies liver cirrhosis as an independent risk factor for mortality among patients hospitalized with ischemic stroke. These findings underscore the necessity of incorporating proactive management strategies for liver cirrhosis into stroke care and prevention protocols, potentially improving outcomes in this high-risk population.
缺血性中风仍然是全球可预防的心血管疾病死亡的主要原因，新出现的证据表明肝硬化与中风的发生和严重程度之间存在关联。然而，肝硬化对中风相关死亡率的具体影响仍未完全明确。阐明这种关系对于改善风险分层和早期识别高危个体至关重要。我们进行了一项回顾性队列研究，使用2021年的全国住院患者样本数据库，将缺血性中风合并肝硬化的患者与未合并肝硬化的患者进行比较。进行单因素和多因素逻辑回归分析以比较各种结果。总共纳入了536,199例缺血性中风出院病例，其中4464例有肝硬化病史。合并肝硬化的出院患者以男性为主（58.2%），平均年龄为67岁，比未合并肝硬化的患者年轻2.17岁。合并肝硬化的出院患者院内死亡率为7%（95%CI：5.5%-8.99%），而未合并肝硬化的患者为4.2%（95%CI：4.0%-4.33%）。在多因素逻辑回归中对混杂因素进行调整后发现，肝硬化与中风出院患者的死亡风险高69%相关（OR = 1.69，95%CI：1.27-2.25，P < 0.001）。我们的研究确定肝硬化是缺血性中风住院患者死亡的独立危险因素。这些发现强调了将肝硬化的积极管理策略纳入中风护理和预防方案的必要性，这可能改善这一高危人群的预后。
