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Impact of Diabetes on Stroke Risk and Outcomes: Two Nationwide Retrospective Cohort Studies

Several limitations existed in previous studies which suggested that diabetic patients have increased risk of stroke. We conducted this study to better understand the stroke risk and poststroke outcomes in patients with diabetes. From the claims data of Taiwan's National Health Insurance, we id...

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Autores principales: Liao, Chien-Chang, Shih, Chun-Chuan, Yeh, Chun-Chieh, Chang, Yi-Cheng, Hu, Chaur-Jong, Lin, Jaung-Geng, Chen, Ta-Liang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291606/
https://www.ncbi.nlm.nih.gov/pubmed/26717365
http://dx.doi.org/10.1097/MD.0000000000002282
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author Liao, Chien-Chang
Shih, Chun-Chuan
Yeh, Chun-Chieh
Chang, Yi-Cheng
Hu, Chaur-Jong
Lin, Jaung-Geng
Chen, Ta-Liang
author_facet Liao, Chien-Chang
Shih, Chun-Chuan
Yeh, Chun-Chieh
Chang, Yi-Cheng
Hu, Chaur-Jong
Lin, Jaung-Geng
Chen, Ta-Liang
author_sort Liao, Chien-Chang
collection PubMed
description Several limitations existed in previous studies which suggested that diabetic patients have increased risk of stroke. We conducted this study to better understand the stroke risk and poststroke outcomes in patients with diabetes. From the claims data of Taiwan's National Health Insurance, we identified 24,027 adults with new-diagnosed diabetes and 96,108 adults without diabetes between 2000 and 2003 in a retrospective cohort study. Stroke events (included hemorrhage, ischemia, and other type of stroke) during the follow-up period of 2000 to 2008 were ascertained and adjusted risk of stroke associated with diabetes was calculated. A nested cohort study of 221,254 hospitalized stroke patients (included hemorrhage, ischemia, and other type of stroke) between 2000 and 2009 was conducted. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for adverse events after stroke hospitalization in patients with and without diabetes. The incidences of stroke in cohorts with and without diabetes were 10.1 and 4.5 per 1000 person-years, respectively. During the follow-up period, diabetic patients had an increased risk of stroke (adjusted hazard ratio: 1.75; 95% CI: 1.64–1.86) than those without diabetes. Associations between diabetes and stroke risk were significant in both sexes and all age groups. Previous diabetes was associated with poststroke mortality (OR: 1.33; 95% CI: 1.19–1.49), pneumonia (OR: 1.30; 95% CI: 1.20–1.42), and urinary tract infection (OR: 1.66; 95% CI: 1.55–1.77). The impact of diabetes on adverse events after stroke was investigated particularly in those with diabetes-related complications. Diabetes was associated with stroke risk, and diabetic patients had more adverse events and subsequent mortality after stroke.
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spelling pubmed-52916062017-02-09 Impact of Diabetes on Stroke Risk and Outcomes: Two Nationwide Retrospective Cohort Studies Liao, Chien-Chang Shih, Chun-Chuan Yeh, Chun-Chieh Chang, Yi-Cheng Hu, Chaur-Jong Lin, Jaung-Geng Chen, Ta-Liang Medicine (Baltimore) 4300 Several limitations existed in previous studies which suggested that diabetic patients have increased risk of stroke. We conducted this study to better understand the stroke risk and poststroke outcomes in patients with diabetes. From the claims data of Taiwan's National Health Insurance, we identified 24,027 adults with new-diagnosed diabetes and 96,108 adults without diabetes between 2000 and 2003 in a retrospective cohort study. Stroke events (included hemorrhage, ischemia, and other type of stroke) during the follow-up period of 2000 to 2008 were ascertained and adjusted risk of stroke associated with diabetes was calculated. A nested cohort study of 221,254 hospitalized stroke patients (included hemorrhage, ischemia, and other type of stroke) between 2000 and 2009 was conducted. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for adverse events after stroke hospitalization in patients with and without diabetes. The incidences of stroke in cohorts with and without diabetes were 10.1 and 4.5 per 1000 person-years, respectively. During the follow-up period, diabetic patients had an increased risk of stroke (adjusted hazard ratio: 1.75; 95% CI: 1.64–1.86) than those without diabetes. Associations between diabetes and stroke risk were significant in both sexes and all age groups. Previous diabetes was associated with poststroke mortality (OR: 1.33; 95% CI: 1.19–1.49), pneumonia (OR: 1.30; 95% CI: 1.20–1.42), and urinary tract infection (OR: 1.66; 95% CI: 1.55–1.77). The impact of diabetes on adverse events after stroke was investigated particularly in those with diabetes-related complications. Diabetes was associated with stroke risk, and diabetic patients had more adverse events and subsequent mortality after stroke. Wolters Kluwer Health 2015-12-31 /pmc/articles/PMC5291606/ /pubmed/26717365 http://dx.doi.org/10.1097/MD.0000000000002282 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial License, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be used commercially. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 4300
Liao, Chien-Chang
Shih, Chun-Chuan
Yeh, Chun-Chieh
Chang, Yi-Cheng
Hu, Chaur-Jong
Lin, Jaung-Geng
Chen, Ta-Liang
Impact of Diabetes on Stroke Risk and Outcomes: Two Nationwide Retrospective Cohort Studies
title Impact of Diabetes on Stroke Risk and Outcomes: Two Nationwide Retrospective Cohort Studies
title_full Impact of Diabetes on Stroke Risk and Outcomes: Two Nationwide Retrospective Cohort Studies
title_fullStr Impact of Diabetes on Stroke Risk and Outcomes: Two Nationwide Retrospective Cohort Studies
title_full_unstemmed Impact of Diabetes on Stroke Risk and Outcomes: Two Nationwide Retrospective Cohort Studies
title_short Impact of Diabetes on Stroke Risk and Outcomes: Two Nationwide Retrospective Cohort Studies
title_sort impact of diabetes on stroke risk and outcomes: two nationwide retrospective cohort studies
topic 4300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291606/
https://www.ncbi.nlm.nih.gov/pubmed/26717365
http://dx.doi.org/10.1097/MD.0000000000002282
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