An Analysis of Long-Term Ischemic Stroke Risk in Survivors of Septicemia.
J Stroke Cerebrovasc Dis
; 26(12): 2893-2900, 2017 Dec.
Article
em En
| MEDLINE
| ID: mdl-28802520
INTRODUCTION: Sepsis increases the long-term incidence of ischemic stroke (IS). The chances for long-term IS in patients who are discharged after sepsis are unclear. Our aim was to demonstrate long-term risk chances of IS after septicemia discharge. We used a nomogram to identify those septicemia survivors with the higher risk of developing IS. METHODS: Inpatient data were used from the Taiwan Longitudinal Health Insurance Database, from 2001 to 2003. The event was IS rehospitalization after discharge of septicemia. We used multivariate Cox proportional regression of the risk factors for IS in septicemia survivors to create a nomogram. RESULTS: There were 642 IS incidents in this study. The risk factors for IS in survivors of septicemia were advanced age (hazard ratio [HR] 1.035 [95% confidence interval (CI) 1.029-1.042]), new-onset atrial fibrillation (HR 1.875 [95% CI 1.327-2.651]), hypertension (HR 2.042 [95% CI 1.687-2.471]), diabetes mellitus (HR 1.735 [95% CI 1.469-2.05]), coronary artery disease (HR 1.661 [95% CI 1.408-1.96]), chronic kidney disease (HR 1.264 [95% CI 1.071-1.49]), chronic obstructive pulmonary disease (HR 1.201 [95% CI 1.016-1.421]), and local hospital admission (HR 1.414 [95% CI 1.155-1.731]). The model showed good calibration and discrimination, with a bootstrap-corrected concordance index of .785. CONCLUSION: With this prognostic nomogram, we found age with the strongest factor for IS. There was increased IS incidence with more comorbid conditions in advance-aged septicemia survivors. Physicians must identify high IS-risk patients and control risk factors to prevent adverse events in the clinical setting.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Isquemia Encefálica
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Sobreviventes
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Sepse
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Acidente Vascular Cerebral
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article