Age- and Sex-Specific Trends in Medical Complications After Acute Ischemic Stroke in the United States

作者：Rashid Ahmed, Carl Mhina, Karan Philip, Smit Patel, Ehimen Aneni, Chukwuemeka U Osondu, Oluwatomi Lamikanra, Emmanuel Akano, Nnabuchi Anikpezie, Karen C. Albright, Julius Gene Latorre, Seemant Chaturvedi, Fadar Oliver Otite · 发表于：Neurology · 年份：2023 · DOI：10.1212/wnl.0000000000206749 · 被引用次数：45 · 研究领域：Acute Ischemic Stroke Management、Venous Thromboembolism Diagnosis and Management、Intracerebral and Subarachnoid Hemorrhage Research

Background and Objectives To test the hypothesis that the age and sex-specific prevalence of infectious (pneumonia, sepsis, and urinary tract infection [UTI]) and noninfectious (deep venous thrombosis [DVT], pulmonary embolism [PE], acute renal failure [ARF], acute myocardial infarction [AMI], and gastrointestinal bleeding [GIB]) complications increased after acute ischemic stroke (AIS) hospitalization in the United States from 2007 to 2019. Methods We conducted a serial cross-sectional study using the 2007–2019 National Inpatient Sample. Primary AIS admissions in adults (aged 18 years or older) with and without complications were identified using International Classification of Diseases codes. We quantified the age/sex-specific prevalence of complications and used negative binomial regression models to evaluate trends over time. Results Of 5,751,601 weighted admissions, 51.4% were women. 25.1% had at least 1 complication. UTI (11.8%), ARF (10.1%), pneumonia (3.2%), and AMI (2.5%) were the most common complications, while sepsis (1.7%), GIB (1.1%), DVT (1.2%), and PE (0.5%) were the least prevalent. Marked disparity in complication risk existed by age/sex (UTI: men 18–39 years 2.1%; women 80 years or older 22.5%). Prevalence of UTI (12.9%–9.7%) and pneumonia (3.8%–2.7%) declined, but that of ARF increased by ≈3-fold (4.8%–14%) over the period 2007–2019 (all p < 0.001). AMI (1.9%–3.1%), DVT (1.0%–1.4%), and PE (0.3%–0.8%) prevalence also increased ( p < 0.001),...