Risk of stroke in patients with dengue fever: a population-based cohort study
ABSTRACT BACKGROUND Stroke is a severe neurologic complication of dengue fever, described in only a few case reports. The incidence and risk factors for stroke in patients with dengue remain unclear. We conducted a population-based retrospective cohort study to investigate the risk of stroke in pati...
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| Veröffentlicht in: | Canadian Medical Association journal (CMAJ) 2018-03, Vol.190 (10), p.E285-E290 |
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| creator | Li, Hao-Ming, MD Huang, Ying-Kai, MD Su, Yuan-Chih, MSc Kao, Chia-Hung, MD |
| description | ABSTRACT BACKGROUND Stroke is a severe neurologic complication of dengue fever, described in only a few case reports. The incidence and risk factors for stroke in patients with dengue remain unclear. We conducted a population-based retrospective cohort study to investigate the risk of stroke in patients with dengue. METHODS Using data from the Taiwan National Health Insurance Research Database, we included a total of 13 787 patients with dengue newly diagnosed between 2000 and 2012. The control cohort consisted of patients who did not have dengue, matched 1:1 by demographic characteristics and stroke-related comorbidities. We calculated the cumulative incidences and hazard ratios (HRs) of stroke in both cohorts using Kaplan–Meier curves and Cox proportional hazards regression. RESULTS The overall incidence rate of stroke was 5.33 per 1000 person-years in the dengue cohort and 3.72 per 1000 person-years in the control cohort, with an adjusted HR of 1.16 (95% confidence interval [CI] 1.01–1.32). The risk of stroke among patients with dengue was highest in the first 2 months after diagnosis (25.53 per 1000 person-years, adjusted HR 2.49, 95% CI 1.48–4.18). INTERPRETATION Dengue fever was associated with an increased risk of stroke in the first few months after diagnosis. The effect of dengue on stroke may be acute rather than chronic. |
| doi_str_mv | 10.1503/cmaj.170994 |
| format | Article |
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The incidence and risk factors for stroke in patients with dengue remain unclear. We conducted a population-based retrospective cohort study to investigate the risk of stroke in patients with dengue. METHODS Using data from the Taiwan National Health Insurance Research Database, we included a total of 13 787 patients with dengue newly diagnosed between 2000 and 2012. The control cohort consisted of patients who did not have dengue, matched 1:1 by demographic characteristics and stroke-related comorbidities. We calculated the cumulative incidences and hazard ratios (HRs) of stroke in both cohorts using Kaplan–Meier curves and Cox proportional hazards regression. RESULTS The overall incidence rate of stroke was 5.33 per 1000 person-years in the dengue cohort and 3.72 per 1000 person-years in the control cohort, with an adjusted HR of 1.16 (95% confidence interval [CI] 1.01–1.32). The risk of stroke among patients with dengue was highest in the first 2 months after diagnosis (25.53 per 1000 person-years, adjusted HR 2.49, 95% CI 1.48–4.18). INTERPRETATION Dengue fever was associated with an increased risk of stroke in the first few months after diagnosis. The effect of dengue on stroke may be acute rather than chronic.</description><identifier>ISSN: 0820-3946</identifier><identifier>EISSN: 1488-2329</identifier><identifier>DOI: 10.1503/cmaj.170994</identifier><identifier>PMID: 29530869</identifier><language>eng</language><publisher>Canada: Joule Inc</publisher><subject>Adult ; Aged ; Cardiac arrhythmia ; Care and treatment ; Codes ; Cohort analysis ; Cohort Studies ; Comorbidity ; Dengue - complications ; Dengue - epidemiology ; Dengue fever ; Disease control ; Female ; Health insurance ; Health risk assessment ; Hospitals ; Humans ; Immunoglobulins ; Infections ; Internal Medicine ; Male ; Medical laboratories ; Medical research ; Middle Aged ; National health insurance ; Online databases ; Patients ; Population ; Population-based studies ; Retrospective Studies ; Risk Assessment - methods ; Risk Factors ; Statistical analysis ; Stroke ; Stroke - epidemiology ; Stroke - etiology ; Stroke patients ; Surveillance ; Taiwan - epidemiology ; Viral infections ; Viruses</subject><ispartof>Canadian Medical Association journal (CMAJ), 2018-03, Vol.190 (10), p.E285-E290</ispartof><rights>Joule Inc. or its licensors</rights><rights>2018 Joule Inc. or its licensors.</rights><rights>COPYRIGHT 2018 Joule Inc.</rights><rights>Copyright Joule Inc Mar 12, 2018</rights><rights>2018 Joule Inc. or its licensors 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c695t-698fcb8f9366f12baa751cf26a214c7c81e1d6c6693b872d38a43fe9bcaee9a63</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849447/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849447/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29530869$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Hao-Ming, MD</creatorcontrib><creatorcontrib>Huang, Ying-Kai, MD</creatorcontrib><creatorcontrib>Su, Yuan-Chih, MSc</creatorcontrib><creatorcontrib>Kao, Chia-Hung, MD</creatorcontrib><title>Risk of stroke in patients with dengue fever: a population-based cohort study</title><title>Canadian Medical Association journal (CMAJ)</title><addtitle>CMAJ</addtitle><description>ABSTRACT BACKGROUND Stroke is a severe neurologic complication of dengue fever, described in only a few case reports. The incidence and risk factors for stroke in patients with dengue remain unclear. We conducted a population-based retrospective cohort study to investigate the risk of stroke in patients with dengue. METHODS Using data from the Taiwan National Health Insurance Research Database, we included a total of 13 787 patients with dengue newly diagnosed between 2000 and 2012. The control cohort consisted of patients who did not have dengue, matched 1:1 by demographic characteristics and stroke-related comorbidities. We calculated the cumulative incidences and hazard ratios (HRs) of stroke in both cohorts using Kaplan–Meier curves and Cox proportional hazards regression. RESULTS The overall incidence rate of stroke was 5.33 per 1000 person-years in the dengue cohort and 3.72 per 1000 person-years in the control cohort, with an adjusted HR of 1.16 (95% confidence interval [CI] 1.01–1.32). The risk of stroke among patients with dengue was highest in the first 2 months after diagnosis (25.53 per 1000 person-years, adjusted HR 2.49, 95% CI 1.48–4.18). INTERPRETATION Dengue fever was associated with an increased risk of stroke in the first few months after diagnosis. The effect of dengue on stroke may be acute rather than chronic.</description><subject>Adult</subject><subject>Aged</subject><subject>Cardiac arrhythmia</subject><subject>Care and treatment</subject><subject>Codes</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Dengue - complications</subject><subject>Dengue - epidemiology</subject><subject>Dengue fever</subject><subject>Disease control</subject><subject>Female</subject><subject>Health insurance</subject><subject>Health risk assessment</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunoglobulins</subject><subject>Infections</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical laboratories</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>National health insurance</subject><subject>Online databases</subject><subject>Patients</subject><subject>Population</subject><subject>Population-based studies</subject><subject>Retrospective Studies</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Stroke - epidemiology</subject><subject>Stroke - etiology</subject><subject>Stroke patients</subject><subject>Surveillance</subject><subject>Taiwan - epidemiology</subject><subject>Viral infections</subject><subject>Viruses</subject><issn>0820-3946</issn><issn>1488-2329</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqV089v0zAUB_AIgVgZnLijiEkIhFL8K47NAWma-DFpgLTB2XKc59ZtGmdxUuh_j6OOrkW9kBwiJR-_vOR9nSTPMZriHNF3ZqUXU1wgKdmDZIKZEBmhRD5MJkgQlFHJ-EnyJIQFigclxePkhMicIsHlJPl67cIy9TYNfeeXkLombXXvoOlD-sv187SCZjZAamEN3ftUp61vhzoK32SlDlClxs9918f1Q7V5mjyyug7w7O56mvz89PHHxZfs6vvny4vzq8xwmfcZl8KaUlhJObeYlFoXOTaWcE0wM4URGHDFDeeSlqIgFRWaUQuyNBpAak5Pkw_buu1QrqAysd1O16rt3Ep3G-W1U4dPGjdXM79WuWCSsSIWeH1XoPO3A4RerVwwUNe6AT8ERRCmORaC5ZGe_UMXfuia-HlREcwFFYzeq5muQbnG-vheMxZV5_Ffc1rkBYoqO6Jm0EBs0jdgXbx94F8e8aZ1t2ofTY-geFawcuZo1TcHC6Lp4Xc_00MI6vLm-j_st0P7as_OQdf9PPh6GMMSDuHbLTSdD6EDu5scRmrMtBozrbaZjvrF_rB39m-I79MAMXJrB50ytWuc0fUSNhB248IqEIXUzbgtxl2BBUWYxX7-AKIQAf0</recordid><startdate>20180312</startdate><enddate>20180312</enddate><creator>Li, Hao-Ming, MD</creator><creator>Huang, Ying-Kai, MD</creator><creator>Su, Yuan-Chih, MSc</creator><creator>Kao, Chia-Hung, MD</creator><general>Joule Inc</general><general>CMA Impact, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>8FV</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M3G</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180312</creationdate><title>Risk of stroke in patients with dengue fever: a population-based cohort study</title><author>Li, Hao-Ming, MD ; Huang, Ying-Kai, MD ; Su, Yuan-Chih, MSc ; Kao, Chia-Hung, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c695t-698fcb8f9366f12baa751cf26a214c7c81e1d6c6693b872d38a43fe9bcaee9a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Cardiac arrhythmia</topic><topic>Care and treatment</topic><topic>Codes</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Dengue - complications</topic><topic>Dengue - epidemiology</topic><topic>Dengue fever</topic><topic>Disease control</topic><topic>Female</topic><topic>Health insurance</topic><topic>Health risk assessment</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Immunoglobulins</topic><topic>Infections</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical laboratories</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>National health insurance</topic><topic>Online databases</topic><topic>Patients</topic><topic>Population</topic><topic>Population-based studies</topic><topic>Retrospective Studies</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>Stroke</topic><topic>Stroke - epidemiology</topic><topic>Stroke - etiology</topic><topic>Stroke patients</topic><topic>Surveillance</topic><topic>Taiwan - epidemiology</topic><topic>Viral infections</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Hao-Ming, MD</creatorcontrib><creatorcontrib>Huang, Ying-Kai, MD</creatorcontrib><creatorcontrib>Su, Yuan-Chih, MSc</creatorcontrib><creatorcontrib>Kao, Chia-Hung, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>Canadian Business & Current Affairs Database (Alumni Edition)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>CBCA Reference & Current Events</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Canadian Medical Association journal (CMAJ)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Hao-Ming, MD</au><au>Huang, Ying-Kai, MD</au><au>Su, Yuan-Chih, MSc</au><au>Kao, Chia-Hung, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of stroke in patients with dengue fever: a population-based cohort study</atitle><jtitle>Canadian Medical Association journal (CMAJ)</jtitle><addtitle>CMAJ</addtitle><date>2018-03-12</date><risdate>2018</risdate><volume>190</volume><issue>10</issue><spage>E285</spage><epage>E290</epage><pages>E285-E290</pages><issn>0820-3946</issn><eissn>1488-2329</eissn><abstract>ABSTRACT BACKGROUND Stroke is a severe neurologic complication of dengue fever, described in only a few case reports. The incidence and risk factors for stroke in patients with dengue remain unclear. We conducted a population-based retrospective cohort study to investigate the risk of stroke in patients with dengue. METHODS Using data from the Taiwan National Health Insurance Research Database, we included a total of 13 787 patients with dengue newly diagnosed between 2000 and 2012. The control cohort consisted of patients who did not have dengue, matched 1:1 by demographic characteristics and stroke-related comorbidities. We calculated the cumulative incidences and hazard ratios (HRs) of stroke in both cohorts using Kaplan–Meier curves and Cox proportional hazards regression. RESULTS The overall incidence rate of stroke was 5.33 per 1000 person-years in the dengue cohort and 3.72 per 1000 person-years in the control cohort, with an adjusted HR of 1.16 (95% confidence interval [CI] 1.01–1.32). The risk of stroke among patients with dengue was highest in the first 2 months after diagnosis (25.53 per 1000 person-years, adjusted HR 2.49, 95% CI 1.48–4.18). INTERPRETATION Dengue fever was associated with an increased risk of stroke in the first few months after diagnosis. The effect of dengue on stroke may be acute rather than chronic.</abstract><cop>Canada</cop><pub>Joule Inc</pub><pmid>29530869</pmid><doi>10.1503/cmaj.170994</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Cardiac arrhythmia Care and treatment Codes Cohort analysis Cohort Studies Comorbidity Dengue - complications Dengue - epidemiology Dengue fever Disease control Female Health insurance Health risk assessment Hospitals Humans Immunoglobulins Infections Internal Medicine Male Medical laboratories Medical research Middle Aged National health insurance Online databases Patients Population Population-based studies Retrospective Studies Risk Assessment - methods Risk Factors Statistical analysis Stroke Stroke - epidemiology Stroke - etiology Stroke patients Surveillance Taiwan - epidemiology Viral infections Viruses |
| title | Risk of stroke in patients with dengue fever: a population-based cohort study |
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