Risk of stroke among patients with post-traumatic stress disorder: nationwide longitudinal study
Risk of stroke among patients with post-traumatic stress disorder: nationwide longitudinal study
复制标题
DOI：
10.1192/bjp.bp.113.143610
复制
发表时间：
2015-04-01
影响因子：
10.5
通讯作者：
Bai, Ya-Mei
中科院分区：
文献类型：
--
作者：
Chen, Mu-Hong;Pan, Tai-Long;Bai, Ya-Mei
背景先前的证据显示创伤后应激障碍（PTSD）与高血压、血脂异常和糖尿病呈正相关，这些都是卒中的危险因素，但创伤后应激障碍在卒中后续发展中的作用尚不清楚。目的探讨创伤后应激障碍与脑卒中发生的时间相关性。方法从台湾全民健康保险研究数据库中筛选5217名年龄在bb0 = 18岁，患有创伤后应激障碍但无卒中史的个体，以及20868名年龄和性别匹配的对照组，于2002年至2009年期间入组，并随访至2011年底，以确定卒中的发展情况。结果：在调整了人口统计数据和医疗合并症后，PTSD患者发生任何中风（风险比（HR） 3.37, 95% CI 2.44-4.67）和缺血性中风（HR = 3.47, 95% Cl 2.23-5.39）的风险增加。在排除第一年的观察后，敏感性试验显示一致的结果（任何卒中HR= 3.02, 95% Cl 2.13-4.28；缺血性卒中HR=2.89, 95% Cl 1.79-4.66）。结论：PTSD患者发生中风和缺血性中风的风险增加。需要进一步的研究来调查潜在的机制。
BackgroundPrevious evidence has shown positive associations between post-traumatic stress disorder (PTSD) and hypertension, dyslipidaemia and diabetes mellitus, which are all risk factors for stroke, but the role of PTSD in the subsequent development of stroke is still unknown.AimsTo investigate the temporal association between PTSD and the development of stroke.MethodIdentified from the Taiwan National Health Insurance Research Database, 5217 individuals aged >= 18 years, with PTSD but with no history of stroke, and 20868 age- and gender-matched controls were enrolled between 2002 and 2009, and followed up until the end of 2011 to identify the development of stroke.ResultsIndividuals with PTSD had an increased risk of developing any stroke (hazard ratio (HR) 3.37, 95% CI 2.44-4.67) and ischaemic stroke (HR = 3.47, 95% Cl 2.23-5.39) after adjusting for demographic data and medical comorbidities. Sensitivity tests showed consistent findings (any stroke HR = 3.02, 95% Cl 2.13-4.28; ischaemic stroke HR=2.89, 95% Cl 1.79-4.66) after excluding the first year of observation.ConclusionsIndividuals with PTSD have an increased risk of developing any stroke and ischaemic stroke. Further studies are required to investigate the underlying mechanisms.