Newly Diagnosed Leptospirosis and Subsequent Hemorrhagic Stroke A Nationwide Population-Based Cohort Study

doi:10.1161/STROKEAHA.120.029998

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23459

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23459

Title:	Newly Diagnosed Leptospirosis and Subsequent Hemorrhagic Stroke A Nationwide Population-Based Cohort Study
Authors:	Li, KY;Chou, MC;Wei, JCC;Lin, MC;Hung, YM;Chang, RN
Keywords:	cohort studies;hemorrhagic stroke;infections;ischemic stroke;leptospirosis
Date:	2021
Issue Date:	2022-08-05T09:37:38Z (UTC)
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
ISSN:	0039-2499
Abstract:	Background and Purpose: Preceding infection as an important risk factor for ischemic stroke has been reported but neglected for hemorrhagic stroke, especially in young and middle-aged patients. This study investigates whether newly diagnosed leptospirosis is associated with an increased risk of stroke. Methods: We identified 3699 in-patients who were aged >= 18 years and newly diagnosed with leptospirosis. We also randomly selected a comparison cohort 14 796 in-patients from the general population by using a propensity score matching method (at a 1:4 ratio). We analyzed the risks of stroke by using Cox proportional hazard regression models. Results: The adjusted hazard ratio (HR; 95% CI) of stroke for the leptospirosis group was 1.14 (0.93-1.38; P=0.200) as opposed to the comparison group after adjusting sex, age, and comorbidities. However, adjusted HR (95% CI) of ischemic stroke and hemorrhagic stroke was 1.01 (0.80-1.29) and 1.58 (1.12-2.23), respectively. The strength of association between leptospirosis and hemorrhagic stroke remained statistically significant after variation of leptospirosis and stroke definitions. The post hoc subgroup analysis indicated that a patient with leptospirosis had a significantly greater risk of hemorrhagic stroke in male (adjusted HR, 1.62 [95% CI, 1.08-2.44]) and individuals between age 18 and 39 (adjusted HR, 3.67 [95% CI, 1.33-10.14]). The risk of hemorrhagic stroke among people with leptospirosis was highest in the first 2 years after diagnosis (adjusted HR, 1.97 [95% CI, 1.15-3.38]). Conclusions: A 2.49-fold risk of stroke was found among the leptospirosis cohort of aged younger than 39 years. Age acted as an effect modifier between the leptospirosis and risk of new-onset stroke.
URI:	http://dx.doi.org/10.1161/STROKEAHA.120.029998 https://www.webofscience.com/wos/woscc/full-record/WOS:000639315700024 https://ir.csmu.edu.tw:8080/handle/310902500/23459
Relation:	STROKE ,2021,v52,issue 3, P913-921
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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