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Risk of subsequent ischemic stroke in patients with nontyphoidal salmonellosis: A nationwide population-based cohort study - 06/08/20

Doi : 10.1016/j.jinf.2020.06.026 
Renin Chang a, b, c, James Cheng-Chung Wei d, e, f, Mei-Chen Lin g, Yao-Min Hung h, i, j, , Chih-Hsin Hung b,
a Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 
b Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung 84001, Taiwan 
c Department of Recreation Sports Management, Tajen University, Pingtung, Taiwan 
d Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taiwan 
e Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan 
f Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan 
g Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan 
h Department of Internal Medicine, Kaohsiung Municipal United Hospital, No. 976, Jhonghua 1st Rd., Gushan Dist., Kaohsiung 80457, Taiwan 
i School of Medicine, National Yang Ming University, Taipei, Taiwan 
j Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan 

Corresponding author at: Department of Internal Medicine, Kaohsiung Municipal United Hospital, No. 976, Jhonghua 1st Rd., Gushan Dist., Kaohsiung 80457, Taiwan.Department of Internal MedicineKaohsiung Municipal United HospitalNo. 976, Jhonghua 1st Rd., Gushan Dist.Kaohsiung80457Taiwan⁎⁎Corresponding author.

Highlights

NTS increased 1.34-risk of developing stroke compared with controls.
Risk was significantly noted especially among females, the elders, and those with some co-morbidities.
NTS increased ischemic stroke, not hemorrhagic stroke in the study.

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Summary

Objectives:

To explore the association between nontyphoidal salmonellosis (NTS) and the risk of acute ischemic stroke (IS) by using a nationwide, population-based study.

Methods

A retrospective cohort study using claim data from Taiwan's National Health Insurance Research Database (NHIRD), patients aged 18 years and older with histories of NTS (N = 1618) were included from January 1, 2000-December 31, 2012, and the non-NTS group (N = 6472) without NTS were matched by propensity score. The follow-up period was defined as the time from the initial diagnosis of NTS to the date of development of IS, death or 31 December, 2013. Patients previously diagnosed with stroke were excluded. The Cox proportional hazard model with robust sandwich estimator was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of IS after adjusting for demographic and clinical covariates.

Results:

The adjusted hazard ratio (aHR) for the NTS group compared with the non-NTS group was 1.34 (95% confidence interval [CI], 1.10–1.65) for overall stroke. Furthermore, the NTS cohort had an increased risk of IS compared to the non-NTS groups (aHR, 1.42; 95% CI, 1.14–1.78). Stratified analysis showed that compared with propensity score matched non-NTS group, subjects aged ≥65 years, female, those with hypertension, hyperlipidemia, COPD, cancer and heart failure had higher risk of developing stroke. A 1.93-fold significant increase risk for stroke was observed during the first 3–12 months of follow-up (95% CI, 1.07–3.48).

Conclusions:

Patients with NTS is associated with increased risk of developing ischemic stroke compared with non-NTS patients. Timely and mindful treatment plan about NTS may be a milestone to stroke prevention especially in some subpopulation.

Le texte complet de cet article est disponible en PDF.

Keyword : Nontyphoidal salmonellosis, Stroke, Cohort study, Ischemic stroke


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Vol 81 - N° 3

P. 396-402 - septembre 2020 Retour au numéro
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