Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study.
BACKGROUND: Although much attention has been focused on the association between chronic hyperglycemia and cerebrovascular diseases in type 2 diabetes mellitus (DM) patients, there is no data regarding the risk of ischemic stroke after a hyperosmolar hyperglycemic state (HHS) attack. The objective of...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3979762?pdf=render |
| _version_ | 1818516782868070400 |
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| author | Jen-Yu Wang Cheng-Yi Wang Yung-Sung Huang Pin-Fan Chen Kuang-Yung Huang Pesus Chou Wei-Cheng Lian Ching-Chih Lee |
| author_facet | Jen-Yu Wang Cheng-Yi Wang Yung-Sung Huang Pin-Fan Chen Kuang-Yung Huang Pesus Chou Wei-Cheng Lian Ching-Chih Lee |
| author_sort | Jen-Yu Wang |
| collection | DOAJ |
| description | BACKGROUND: Although much attention has been focused on the association between chronic hyperglycemia and cerebrovascular diseases in type 2 diabetes mellitus (DM) patients, there is no data regarding the risk of ischemic stroke after a hyperosmolar hyperglycemic state (HHS) attack. The objective of this study was to investigate the risk of ischemic stroke in type 2 DM patients after an HHS attack. METHODS: From 2004 to 2008, this retrospective observational study was conducted on a large cohort of Taiwanese using Taiwan's National Health Insurance Research Database (NHIRD). We identified 19,031 type 2 DM patients who were discharged with a diagnosis of HHS and 521,229 type 2 DM patients without an HHS diagnosis. Using the propensity score generated from logistic regression models, conditional on baseline covariates, we matched 19,031 type 2 DM patients with an HHS diagnosis with the same number from the comparison cohort. The one-year cumulative rate for ischemic stroke was estimated using the Kaplan-Meier method. After adjusting covariates, Cox proportional hazard regression was used to compute the adjusted one-year rate of ischemic stroke. RESULTS: Of the patients sampled, 1,810 (9.5%) of the type 2 DM patients with HHS and 996 (5.2%) of the comparison cohort developed ischemic stroke during the one-year follow-up period. After adjusting for covariates, the adjusted HR for developing ischemic stroke during the one-year follow-up period was 1.8 (95% C.I., 1.67 to 1.95, P<0.001) for type 2 DM patients with HHS compared with those without HHS. CONCLUSION: Although DM is a well-recognized risk factor for atherosclerosis, type 2 DM patients that have suffered a HHS attacks are at an increased risk of developing ischemic stroke compared with those without HHS. |
| first_indexed | 2024-12-11T00:47:07Z |
| format | Article |
| id | doaj.art-02edcb55155c479b9a678c91d78cd84d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T00:47:07Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-02edcb55155c479b9a678c91d78cd84d2022-12-22T01:26:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9415510.1371/journal.pone.0094155Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study.Jen-Yu WangCheng-Yi WangYung-Sung HuangPin-Fan ChenKuang-Yung HuangPesus ChouWei-Cheng LianChing-Chih LeeBACKGROUND: Although much attention has been focused on the association between chronic hyperglycemia and cerebrovascular diseases in type 2 diabetes mellitus (DM) patients, there is no data regarding the risk of ischemic stroke after a hyperosmolar hyperglycemic state (HHS) attack. The objective of this study was to investigate the risk of ischemic stroke in type 2 DM patients after an HHS attack. METHODS: From 2004 to 2008, this retrospective observational study was conducted on a large cohort of Taiwanese using Taiwan's National Health Insurance Research Database (NHIRD). We identified 19,031 type 2 DM patients who were discharged with a diagnosis of HHS and 521,229 type 2 DM patients without an HHS diagnosis. Using the propensity score generated from logistic regression models, conditional on baseline covariates, we matched 19,031 type 2 DM patients with an HHS diagnosis with the same number from the comparison cohort. The one-year cumulative rate for ischemic stroke was estimated using the Kaplan-Meier method. After adjusting covariates, Cox proportional hazard regression was used to compute the adjusted one-year rate of ischemic stroke. RESULTS: Of the patients sampled, 1,810 (9.5%) of the type 2 DM patients with HHS and 996 (5.2%) of the comparison cohort developed ischemic stroke during the one-year follow-up period. After adjusting for covariates, the adjusted HR for developing ischemic stroke during the one-year follow-up period was 1.8 (95% C.I., 1.67 to 1.95, P<0.001) for type 2 DM patients with HHS compared with those without HHS. CONCLUSION: Although DM is a well-recognized risk factor for atherosclerosis, type 2 DM patients that have suffered a HHS attacks are at an increased risk of developing ischemic stroke compared with those without HHS.http://europepmc.org/articles/PMC3979762?pdf=render |
| spellingShingle | Jen-Yu Wang Cheng-Yi Wang Yung-Sung Huang Pin-Fan Chen Kuang-Yung Huang Pesus Chou Wei-Cheng Lian Ching-Chih Lee Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study. PLoS ONE |
| title | Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study. |
| title_full | Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study. |
| title_fullStr | Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study. |
| title_full_unstemmed | Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study. |
| title_short | Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study. |
| title_sort | increased risk of ischemic stroke after hyperosmolar hyperglycemic state a population based follow up study |
| url | http://europepmc.org/articles/PMC3979762?pdf=render |
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