Outcomes after Stroke in Patients with Previous Pressure Ulcer: A Nationwide Matched Retrospective Cohort Study

Shang Yi Lee, Chia Lun Chou, Sanford P C Hsu, Chun Chuan Shih, Chun Chieh Yeh, Chih Jen Hung, Ta Liang Chen, Chien Chang Liao

研究成果: 雜誌貢獻文章

7 引文 (Scopus)

摘要

Background Factors associated with poststroke adverse events were not completely understood. The purpose of this study was to investigate whether stroke patients with previous pressure ulcers had more adverse events after stroke. Methods Using the claims data from Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study matched by propensity score. Three thousand two first-ever stroke patients with previous pressure ulcer and 3002 first-ever stroke patients without pressure ulcer were investigated between 2002 and 2009. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of complications and 30-day mortality after stroke associated with previous pressure ulcer were calculated in the multivariate logistic regressions. Results Patients with pressure ulcer had significantly higher risk than control for poststroke urinary tract infection (OR: 1.56, 95% CI: 1.38-1.78), pneumonia (OR: 1.35, 95% CI: 1.16-1.58), gastrointestinal bleeding (OR: 1.31, 95% CI: 1.04-1.66), and epilepsy (OR: 1.84, 95% CI: 1.83-1.85). Stroke patients with pressure ulcer had increased 30-day poststroke mortality (OR: 2.01, 95% CI: 1.55-2.61), particularly in those treated with debridement (OR: 2.87, 95% CI: 1.85-4.44) or high quantity of antibiotics (OR: 4.01, 95% CI: 2.10-7.66). Pressure ulcer was associated with poststroke mortality in both genders and patients aged 60 years or older. Conclusions This study showed increased poststroke complications and mortality in patients with previous pressure ulcer, which suggests the urgent need for monitoring stroke patients for pressure ulcer history.

原文英語
頁(從 - 到)220-227
頁數8
期刊Journal of Stroke and Cerebrovascular Diseases
25
發行號1
DOIs
出版狀態已發佈 - 一月 1 2016

指紋

Pressure Ulcer
Cohort Studies
Retrospective Studies
Stroke
Odds Ratio
Confidence Intervals
Mortality
Propensity Score
National Health Programs
Physiologic Monitoring
Debridement
Taiwan
Urinary Tract Infections
Epilepsy
Pneumonia
Logistic Models
Databases
Hemorrhage
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

引用此文

Outcomes after Stroke in Patients with Previous Pressure Ulcer : A Nationwide Matched Retrospective Cohort Study. / Lee, Shang Yi; Chou, Chia Lun; Hsu, Sanford P C; Shih, Chun Chuan; Yeh, Chun Chieh; Hung, Chih Jen; Chen, Ta Liang; Liao, Chien Chang.

於: Journal of Stroke and Cerebrovascular Diseases, 卷 25, 編號 1, 01.01.2016, p. 220-227.

研究成果: 雜誌貢獻文章

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title = "Outcomes after Stroke in Patients with Previous Pressure Ulcer: A Nationwide Matched Retrospective Cohort Study",
abstract = "Background Factors associated with poststroke adverse events were not completely understood. The purpose of this study was to investigate whether stroke patients with previous pressure ulcers had more adverse events after stroke. Methods Using the claims data from Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study matched by propensity score. Three thousand two first-ever stroke patients with previous pressure ulcer and 3002 first-ever stroke patients without pressure ulcer were investigated between 2002 and 2009. Adjusted odds ratios (ORs) and 95{\%} confidence intervals (CIs) of complications and 30-day mortality after stroke associated with previous pressure ulcer were calculated in the multivariate logistic regressions. Results Patients with pressure ulcer had significantly higher risk than control for poststroke urinary tract infection (OR: 1.56, 95{\%} CI: 1.38-1.78), pneumonia (OR: 1.35, 95{\%} CI: 1.16-1.58), gastrointestinal bleeding (OR: 1.31, 95{\%} CI: 1.04-1.66), and epilepsy (OR: 1.84, 95{\%} CI: 1.83-1.85). Stroke patients with pressure ulcer had increased 30-day poststroke mortality (OR: 2.01, 95{\%} CI: 1.55-2.61), particularly in those treated with debridement (OR: 2.87, 95{\%} CI: 1.85-4.44) or high quantity of antibiotics (OR: 4.01, 95{\%} CI: 2.10-7.66). Pressure ulcer was associated with poststroke mortality in both genders and patients aged 60 years or older. Conclusions This study showed increased poststroke complications and mortality in patients with previous pressure ulcer, which suggests the urgent need for monitoring stroke patients for pressure ulcer history.",
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author = "Lee, {Shang Yi} and Chou, {Chia Lun} and Hsu, {Sanford P C} and Shih, {Chun Chuan} and Yeh, {Chun Chieh} and Hung, {Chih Jen} and Chen, {Ta Liang} and Liao, {Chien Chang}",
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T1 - Outcomes after Stroke in Patients with Previous Pressure Ulcer

T2 - A Nationwide Matched Retrospective Cohort Study

AU - Lee, Shang Yi

AU - Chou, Chia Lun

AU - Hsu, Sanford P C

AU - Shih, Chun Chuan

AU - Yeh, Chun Chieh

AU - Hung, Chih Jen

AU - Chen, Ta Liang

AU - Liao, Chien Chang

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N2 - Background Factors associated with poststroke adverse events were not completely understood. The purpose of this study was to investigate whether stroke patients with previous pressure ulcers had more adverse events after stroke. Methods Using the claims data from Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study matched by propensity score. Three thousand two first-ever stroke patients with previous pressure ulcer and 3002 first-ever stroke patients without pressure ulcer were investigated between 2002 and 2009. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of complications and 30-day mortality after stroke associated with previous pressure ulcer were calculated in the multivariate logistic regressions. Results Patients with pressure ulcer had significantly higher risk than control for poststroke urinary tract infection (OR: 1.56, 95% CI: 1.38-1.78), pneumonia (OR: 1.35, 95% CI: 1.16-1.58), gastrointestinal bleeding (OR: 1.31, 95% CI: 1.04-1.66), and epilepsy (OR: 1.84, 95% CI: 1.83-1.85). Stroke patients with pressure ulcer had increased 30-day poststroke mortality (OR: 2.01, 95% CI: 1.55-2.61), particularly in those treated with debridement (OR: 2.87, 95% CI: 1.85-4.44) or high quantity of antibiotics (OR: 4.01, 95% CI: 2.10-7.66). Pressure ulcer was associated with poststroke mortality in both genders and patients aged 60 years or older. Conclusions This study showed increased poststroke complications and mortality in patients with previous pressure ulcer, which suggests the urgent need for monitoring stroke patients for pressure ulcer history.

AB - Background Factors associated with poststroke adverse events were not completely understood. The purpose of this study was to investigate whether stroke patients with previous pressure ulcers had more adverse events after stroke. Methods Using the claims data from Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study matched by propensity score. Three thousand two first-ever stroke patients with previous pressure ulcer and 3002 first-ever stroke patients without pressure ulcer were investigated between 2002 and 2009. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of complications and 30-day mortality after stroke associated with previous pressure ulcer were calculated in the multivariate logistic regressions. Results Patients with pressure ulcer had significantly higher risk than control for poststroke urinary tract infection (OR: 1.56, 95% CI: 1.38-1.78), pneumonia (OR: 1.35, 95% CI: 1.16-1.58), gastrointestinal bleeding (OR: 1.31, 95% CI: 1.04-1.66), and epilepsy (OR: 1.84, 95% CI: 1.83-1.85). Stroke patients with pressure ulcer had increased 30-day poststroke mortality (OR: 2.01, 95% CI: 1.55-2.61), particularly in those treated with debridement (OR: 2.87, 95% CI: 1.85-4.44) or high quantity of antibiotics (OR: 4.01, 95% CI: 2.10-7.66). Pressure ulcer was associated with poststroke mortality in both genders and patients aged 60 years or older. Conclusions This study showed increased poststroke complications and mortality in patients with previous pressure ulcer, which suggests the urgent need for monitoring stroke patients for pressure ulcer history.

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KW - mortality

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KW - stroke

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