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Risk of Stroke and Post-Stroke Adverse Events in Patients with Exacerbations of Chronic Obstructive Pulmonary Disease

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  • Chao-Shun Lin
  • Chun-Chuan Shih
  • Chun-Chieh Yeh
  • Chaur-Jong Hu
  • Chi-Li Chung
  • Ta-Liang Chen
  • Chien-Chang Liao

Abstract

Background: The risk and outcomes of stroke in patients with chronic obstructive pulmonary disease exacerbations (COPDe) remain unclear. We examined whether patients with COPDe faced increased risk of stroke or post-stroke outcomes. Methods: Using Taiwan’s National Health Insurance Research Database, we identified 1918 adults with COPDe and selected comparison cohorts of 3836 adults with COPD no exacerbations and 7672 adults without COPD who were frequency matched by age and sex in 2000–2008 (Study 1). Stroke event was identified during 2000–2013 follow-up period. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke associated with COPDe were calculated. In a nested cohort study (Study 2) of 261686 new-diagnosed stroke patients in 2000–2009, we calculated adjusted odds ratios (ORs) and 95% CIs of adverse events after stroke in patients with COPDe. Results: Patients with COPDe had increased stroke incidence, with an adjusted HR of 1.28 (95% CI, 1.03–1.59). In the Study 2, COPDe were associated with post-stroke mortality (OR, 1.34, 95% CI 1.20–1.52), epilepsy (OR, 1.43; 95% CI, (1.22–1.67), and pneumonia (OR, 1.50; 95% CI, 1.39–1.62). Previous intubation for COPD and inpatient admissions due to COPD were factors associated with post-stroke adverse events. Conclusion: Patients who have had COPDe face increased risks of stroke and post-stroke adverse events.

Suggested Citation

  • Chao-Shun Lin & Chun-Chuan Shih & Chun-Chieh Yeh & Chaur-Jong Hu & Chi-Li Chung & Ta-Liang Chen & Chien-Chang Liao, 2017. "Risk of Stroke and Post-Stroke Adverse Events in Patients with Exacerbations of Chronic Obstructive Pulmonary Disease," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-14, January.
    • Handle: RePEc:plo:pone00:0169429
    DOI: 10.1371/journal.pone.0169429
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    1. Marian Ryan & Jose A Suaya & John D Chapman & William B Stason & Donald S Shepard & Cindy Parks Thomas, 2013. "Incidence and Cost of Pneumonia in Older Adults with COPD in the United States," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-1, October.
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    1. Chao-Shun Lin & Chih-Chung Liu & Chun-Chieh Yeh & Yi-Cheng Chang & Chi-Li Chung & Hsin-Long Lane & Chun-Chuan Shih & Ta-Liang Chen & Chien-Chang Liao, 2017. "Diabetes risks and outcomes in chronic obstructive pulmonary disease patients: Two nationwide population-based retrospective cohort studies," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-12, August.

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