Influenza-Like Illness is Associated with Increased Short-Term Risk of Cervical Artery Dissection.
Influenza-Like Illness is Associated with Increased Short-Term Risk of Cervical Artery Dissection.
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DOI：
10.1016/j.jstrokecerebrovasdis.2020.105490
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发表时间：
2021-02
影响因子：
2.5
通讯作者：
Elkind, Mitchell S., V
中科院分区：
文献类型：
--
作者：
Hunter, Madeleine D.;Moon, Yeseon P.;Miller, Eliza C.;Kulick, Erin R.;Boehme, Amelia K.;Elkind, Mitchell S., V
非创伤性颈动脉夹层（CeAD）是年轻人缺血性中风的主要原因。流感样疾病 (ILI) 会引发缺血性中风。我们假设流感和流感样疾病与 CeAD 有关。在纽约州 (NYS) 卫生部全州规划和研究合作系统 (2006-2014) 内的一项病例交叉研究中，我们使用 ICD-9 代码排除重大创伤并定义 CeAD、流感，并使用疾病控制中心定义的 ILI。我们通过比较 CeAD 之前的时间间隔（0-30、0-90、0-180 和 0-365 天）（病例期）的患病率与一年前和两年前（对照期）的患病率，估计了 ILI 和流感与 CeAD 的关联。条件逻辑回归模型生成优势比和 95% 置信区间（OR，95% CI）。模型根据纽约州流感流行率的估计进行了调整。我们的样本包括 3,610 例 CeAD 病例（平均年龄 52±16 岁，54.7% 男性，6.2% 西班牙裔，9.9% 黑人，68.7% 白人）。在病例期间，7.3% 的人患有一种或多种流感样疾病。与一年前和两年前的相同时间间隔相比，CeAD 后 90 天内发生 ILI 的可能性更大（0–15 天：调整后 OR 1.88，95%CI 1.20–2.94；0–30 天：调整后 OR 1.74，95%CI 1.22–2.46；0–90 天：调整后 OR 1.35，95%CI 1.00–1.81）。流感随 CeAD 呈趋势（调整后 OR 1.86，95%CI 0.37-9.24），但由于确诊流感病例有限，这些结果并不具有统计显着性。 ILI 可能会增加 CeAD 的风险 15 天，甚至可能长达 3 个月。
Non-traumatic Cervical Artery Dissection (CeAD) is a leading cause of ischemic stroke in the young. Influenza-like illnesses (ILI) trigger ischemic strokes. We hypothesized that influenza and ILI are associated with CeAD. In a case-crossover study within the New York State (NYS) Department of Health State-wide Planning and Research Cooperative System (2006–2014), we used ICD-9 codes to exclude major trauma and to define CeAD, influenza, and the Centers for Disease Control defined ILI. We estimated the association of ILI and influenza with CeAD by comparing their prevalence in intervals immediately prior (0–30, 0–90,0–180, and 0–365 days) to CeAD (case period) to their prevalence exactly one and two years earlier (control periods). Conditional logistic regression models generated odds ratios and 95% confidence intervals (OR, 95% CI). Models were adjusted for NYS estimates of influenza prevalence rates. Our sample included 3,610 cases of CeAD (mean age 52±16 years, 54.7% male, 6.2% Hispanic, 9.9% Black, 68.7% White). During case periods, 7.3% had one or more ILI. ILI was more likely within 90 days of CeAD compared to the same time interval one and two years before (0–15 days: adjusted OR 1.88, 95%CI 1.20–2.94; 0–30 days: adjusted OR 1.74, 95%CI 1.22–2.46; 0–90 days: adjusted OR 1.35, 95%CI 1.00–1.81). Influenza trended with CeAD (adjusted OR 1.86, 95%CI 0.37–9.24), but these results were not statistically significant, due to limited instances of confirmed influenza. ILI may increase risk of CeAD for 15 days, and possibly up to three months.
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