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

Author

Listed:
  • Shih-Wei Liu

    (Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan)

  • Liang-Chung Huang

    (Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan)

  • Wu-Fu Chung

    (Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan)

  • Hsuan-Kan Chang

    (Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan)

  • Jau-Ching Wu

    (Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
    School of Medicine, National Yang-Ming University, Taipei 112, Taiwan)

  • Li-Fu Chen

    (Department of Emergency Medicine, National Yang-Ming University Hospital, I-Lan 260, Taiwan
    School of Medicine, National Yang-Ming University, Taipei 112, Taiwan)

  • Yu-Chun Chen

    (School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
    Department of Medical Research and Education, National Yang-Ming University Hospital, I-Lan 260, Taiwan
    Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei 112, Taiwan)

  • Wen-Cheng Huang

    (Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
    School of Medicine, National Yang-Ming University, Taipei 112, Taiwan)

  • Henrich Cheng

    (Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan
    Institute of Pharmacology, National Yang-Ming University, Taipei 112, Taiwan)

  • Su-Shun Lo

    (School of Medicine, National Yang-Ming University, Taipei 112, Taiwan)

Abstract

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.

Suggested Citation

  • Shih-Wei Liu & Liang-Chung Huang & Wu-Fu Chung & Hsuan-Kan Chang & Jau-Ching Wu & Li-Fu Chen & Yu-Chun Chen & Wen-Cheng Huang & Henrich Cheng & Su-Shun Lo, 2017. "Increased Risk of Stroke in Patients of Concussion: A Nationwide Cohort Study," IJERPH, MDPI, vol. 14(3), pages 1-12, February.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:3:p:230-:d:91466
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    References listed on IDEAS

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    1. Yi-Kung Lee & Sheng-Wen Hou & Ching-Chih Lee & Chen-Yang Hsu & Yung-Sung Huang & Yung-Cheng Su, 2013. "Increased Risk of Dementia in Patients with Mild Traumatic Brain Injury: A Nationwide Cohort Study," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-7, May.
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