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| [PMID]: | 26742804 |
| [Au] Autor: | Lerario MP; Merkler AE; Gialdini G; Parikh NS; Navi BB; Kamel H |
| [Ad] Endereço: | From the Department of Neurology (M.P.L., A.E.M., N.S.P., B.B.N., H.K.) and Feil Family Brain and Mind Research Institute (G.G., B.B.N., H.K.), Weill Cornell Medical College, New York, NY. mpl9005@med.cornell.edu. |
| [Ti] Título: | Risk of Stroke After the International Classification of Diseases-Ninth Revision Discharge Code Diagnosis of Hypertensive Encephalopathy. |
| [So] Source: | Stroke;47(2):372-5, 2016 Feb. | | [Is] ISSN: | 1524-4628 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | BACKGROUND AND PURPOSE: Although chronic hypertension is a well-established risk factor for stroke, little is known about stroke risk after hypertensive encephalopathy (HE), when neurologic sequelae of hypertension become evident. Therefore, we evaluated the risk of stroke after a diagnosis of HE. METHODS: We identified all patients discharged from California, New York, and Florida emergency departments and acute care hospitals between 2005 and 2012 with a primary International Classification of Diseases, Ninth Edition, Clinical Modification discharge diagnosis of HE (437.2). Patients discharged with a primary diagnosis of seizure (345.x) served as negative controls, whereas patients with a primary diagnosis of transient ischemic attack (435.x) were positive controls. Our primary outcome was the composite of subsequent ischemic stroke or intracerebral hemorrhage. Kaplan-Meier survival statistics were used to calculate cumulative outcome rates, and Cox proportional hazard analysis was used to examine the association between index disease types and outcomes while adjusting for vascular risk factors. RESULTS: We identified 8233 patients with HE, 191 091 with seizure, and 308 680 with transient ischemic attack. The 1-year cumulative rate of ischemic stroke or intracerebral hemorrhage after HE was 4.90% (95% confidence interval [CI], 4.45-5.40) when compared with 0.92% (95% CI, 0.88-0.97) after seizure and 4.49% (95% CI, 4.42-4.57) after transient ischemic attack. The risk of intracerebral hemorrhage was significantly elevated in those with HE (hazard ratio, 2.0; 95% CI, 1.7-2.5) but not in those with transient ischemic attack (hazard ratio, 1.0; 95% CI, 0.9-1.1), when compared with seizure patients. CONCLUSIONS: Patients discharged with a diagnosis of HE face a high risk of future cerebrovascular events, particularly intracerebral hemorrhage. |
| [Mh] Termos MeSH primário: |
Isquemia Encefálica/epidemiologia
Hemorragia Cerebral/epidemiologia
Hipertensão/epidemiologia
Encefalopatia Hipertensiva/epidemiologia
Acidente Vascular Cerebral/epidemiologia
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| [Mh] Termos MeSH secundário: |
Isquemia Encefálica/complicações
California/epidemiologia
Estudos de Casos e Controles
Hemorragia Cerebral/complicações
Estudos de Coortes
Feminino
Florida/epidemiologia
Seres Humanos
Classificação Internacional de Doenças
Ataque Isquêmico Transitório/epidemiologia
Estimativa de Kaplan-Meier
Masculino
New York/epidemiologia
Alta do Paciente
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores de Risco
Convulsões/epidemiologia
Acidente Vascular Cerebral/etiologia
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T |
| [Em] Mês de entrada: | 1606 |
| [Cu] Atualização por classe: | 170201 |
[Lr] Data última revisão:
| 170201 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 160109 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1161/STROKEAHA.115.011992 |
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