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Epilepsy is associated with higher subsequent mortality risk in patients after stroke: a population-based cohort study in Taiwan

Objective: To use the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients with poststroke epilepsy (PSE) in Taiwan have an increased risk of mortality. Methods: We analyzed the data from the NHIRD of patients (≥40 years) who had received stroke diagnoses betwe...

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Autores principales: Harnod, Tomor, Lin, Cheng-Li, Kao, Chia-Hung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489573/
https://www.ncbi.nlm.nih.gov/pubmed/31114385
http://dx.doi.org/10.2147/CLEP.S201263
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author Harnod, Tomor
Lin, Cheng-Li
Kao, Chia-Hung
author_facet Harnod, Tomor
Lin, Cheng-Li
Kao, Chia-Hung
author_sort Harnod, Tomor
collection PubMed
description Objective: To use the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients with poststroke epilepsy (PSE) in Taiwan have an increased risk of mortality. Methods: We analyzed the data from the NHIRD of patients (≥40 years) who had received stroke diagnoses between 2000 and 2012. The patients with stroke were divided into PSE and poststroke non-epilepsy (PSN) cohorts and compared against a sex-, age-, comorbidity-, and index-date-matched cohort from normal population. We calculated adjusted HRs (aHRs) and 95% CIs of all-cause mortality risk in these cohorts after adjustment for age, sex, and comorbidities. Results: Among the poststroke patients, 12.14% constituted the PSE cohort. The cumulative mortality rate was considerably higher in the PSE than in the PSN cohort. The PSE (aHR=4.18, 95% CI=3.91–4.48) and PSN (aHR=1.90, 95% CI=1.83–1.98) cohorts were associated with higher risks of mortality than the comparison cohort. Furthermore, advanced age (≥65 years), male sex, alcohol-related illness, chronic obstructive pulmonary disease, coronary artery disease, diabetes, hypertension, asthma, and cancer would further increase the risk of mortality after a stroke event. Conclusion: The mortality risk in poststroke patients is approximately two times the likelihood in those with PSE than in those without, and approximately four times higher than that in the normal population. Our findings provide crucial information for clinicians and the government to improve survival after stroke.
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spelling pubmed-64895732019-05-21 Epilepsy is associated with higher subsequent mortality risk in patients after stroke: a population-based cohort study in Taiwan Harnod, Tomor Lin, Cheng-Li Kao, Chia-Hung Clin Epidemiol Original Research Objective: To use the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients with poststroke epilepsy (PSE) in Taiwan have an increased risk of mortality. Methods: We analyzed the data from the NHIRD of patients (≥40 years) who had received stroke diagnoses between 2000 and 2012. The patients with stroke were divided into PSE and poststroke non-epilepsy (PSN) cohorts and compared against a sex-, age-, comorbidity-, and index-date-matched cohort from normal population. We calculated adjusted HRs (aHRs) and 95% CIs of all-cause mortality risk in these cohorts after adjustment for age, sex, and comorbidities. Results: Among the poststroke patients, 12.14% constituted the PSE cohort. The cumulative mortality rate was considerably higher in the PSE than in the PSN cohort. The PSE (aHR=4.18, 95% CI=3.91–4.48) and PSN (aHR=1.90, 95% CI=1.83–1.98) cohorts were associated with higher risks of mortality than the comparison cohort. Furthermore, advanced age (≥65 years), male sex, alcohol-related illness, chronic obstructive pulmonary disease, coronary artery disease, diabetes, hypertension, asthma, and cancer would further increase the risk of mortality after a stroke event. Conclusion: The mortality risk in poststroke patients is approximately two times the likelihood in those with PSE than in those without, and approximately four times higher than that in the normal population. Our findings provide crucial information for clinicians and the government to improve survival after stroke. Dove 2019-04-11 /pmc/articles/PMC6489573/ /pubmed/31114385 http://dx.doi.org/10.2147/CLEP.S201263 Text en © 2019 Harnod et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Harnod, Tomor
Lin, Cheng-Li
Kao, Chia-Hung
Epilepsy is associated with higher subsequent mortality risk in patients after stroke: a population-based cohort study in Taiwan
title Epilepsy is associated with higher subsequent mortality risk in patients after stroke: a population-based cohort study in Taiwan
title_full Epilepsy is associated with higher subsequent mortality risk in patients after stroke: a population-based cohort study in Taiwan
title_fullStr Epilepsy is associated with higher subsequent mortality risk in patients after stroke: a population-based cohort study in Taiwan
title_full_unstemmed Epilepsy is associated with higher subsequent mortality risk in patients after stroke: a population-based cohort study in Taiwan
title_short Epilepsy is associated with higher subsequent mortality risk in patients after stroke: a population-based cohort study in Taiwan
title_sort epilepsy is associated with higher subsequent mortality risk in patients after stroke: a population-based cohort study in taiwan
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489573/
https://www.ncbi.nlm.nih.gov/pubmed/31114385
http://dx.doi.org/10.2147/CLEP.S201263
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