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Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study

Long-term morbidities can develop after traumatic brain injury (TBI). Some studies have suggested that the risk of stroke is higher after TBI, but the association between concussion and stroke remains unclear. Using a national cohort, the authors analyzed the incidence of both hemorrhagic and ischem...

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Autores principales: Liu, Shih-Wei, Huang, Liang-Chung, Chung, Wu-Fu, Chang, Hsuan-Kan, Wu, Jau-Ching, Chen, Li-Fu, Chen, Yu-Chun, Huang, Wen-Cheng, Cheng, Henrich, Lo, Su-Shun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369066/
https://www.ncbi.nlm.nih.gov/pubmed/28245607
http://dx.doi.org/10.3390/ijerph14030230
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author Liu, Shih-Wei
Huang, Liang-Chung
Chung, Wu-Fu
Chang, Hsuan-Kan
Wu, Jau-Ching
Chen, Li-Fu
Chen, Yu-Chun
Huang, Wen-Cheng
Cheng, Henrich
Lo, Su-Shun
author_facet Liu, Shih-Wei
Huang, Liang-Chung
Chung, Wu-Fu
Chang, Hsuan-Kan
Wu, Jau-Ching
Chen, Li-Fu
Chen, Yu-Chun
Huang, Wen-Cheng
Cheng, Henrich
Lo, Su-Shun
author_sort Liu, Shih-Wei
collection PubMed
description Long-term morbidities can develop after traumatic brain injury (TBI). Some studies have suggested that the risk of stroke is higher after TBI, but the association between concussion and stroke remains unclear. Using a national cohort, the authors analyzed the incidence of both hemorrhagic and ischemic strokes in patients with previous concussion. A representative cohort of approximately one million people was followed up for four years. Patients with new-onset concussion were identified (n = 13,652) as the concussion group. Subsequently, the incidence rates of later stroke events in the concussion group were compared to a sex-, age- and propensity score–matched comparison group (n = 13,652). The overall incidence rate of stroke in the concussion group was higher than that of the comparison group (9.63 versus 6.52 per 1000 person-years, p < 0.001). Significantly higher stroke risk was observed in the concussion group than in the comparison group (crude hazard ratio 1.48, p < 0.001; adjusted HR 1.65, p < 0.001). In the concussion group, the cumulative incidence rates of both ischemic stroke and hemorrhagic stroke were higher than those of the comparison group (8.9% vs. 5.8% and 2.7% vs. 1.6%, respectively, both p < 0.001). Concussion is an independent risk factor for both ischemic and hemorrhagic strokes. Prevention and monitoring strategies of stroke are therefore suggested for patients who have experienced concussion.
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spelling pubmed-53690662017-04-05 Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study Liu, Shih-Wei Huang, Liang-Chung Chung, Wu-Fu Chang, Hsuan-Kan Wu, Jau-Ching Chen, Li-Fu Chen, Yu-Chun Huang, Wen-Cheng Cheng, Henrich Lo, Su-Shun Int J Environ Res Public Health Article Long-term morbidities can develop after traumatic brain injury (TBI). Some studies have suggested that the risk of stroke is higher after TBI, but the association between concussion and stroke remains unclear. Using a national cohort, the authors analyzed the incidence of both hemorrhagic and ischemic strokes in patients with previous concussion. A representative cohort of approximately one million people was followed up for four years. Patients with new-onset concussion were identified (n = 13,652) as the concussion group. Subsequently, the incidence rates of later stroke events in the concussion group were compared to a sex-, age- and propensity score–matched comparison group (n = 13,652). The overall incidence rate of stroke in the concussion group was higher than that of the comparison group (9.63 versus 6.52 per 1000 person-years, p < 0.001). Significantly higher stroke risk was observed in the concussion group than in the comparison group (crude hazard ratio 1.48, p < 0.001; adjusted HR 1.65, p < 0.001). In the concussion group, the cumulative incidence rates of both ischemic stroke and hemorrhagic stroke were higher than those of the comparison group (8.9% vs. 5.8% and 2.7% vs. 1.6%, respectively, both p < 0.001). Concussion is an independent risk factor for both ischemic and hemorrhagic strokes. Prevention and monitoring strategies of stroke are therefore suggested for patients who have experienced concussion. MDPI 2017-02-25 2017-03 /pmc/articles/PMC5369066/ /pubmed/28245607 http://dx.doi.org/10.3390/ijerph14030230 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liu, Shih-Wei
Huang, Liang-Chung
Chung, Wu-Fu
Chang, Hsuan-Kan
Wu, Jau-Ching
Chen, Li-Fu
Chen, Yu-Chun
Huang, Wen-Cheng
Cheng, Henrich
Lo, Su-Shun
Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study
title Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study
title_full Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study
title_fullStr Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study
title_full_unstemmed Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study
title_short Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study
title_sort increased risk of stroke in patients of concussion: a nationwide cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369066/
https://www.ncbi.nlm.nih.gov/pubmed/28245607
http://dx.doi.org/10.3390/ijerph14030230
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