title: Increased risk of stroke among patients with ulcerative colitis: a population-based matched cohort study.
abstract: BACKGROUND
  The risk of venous thromboembolism (VTE) and the development of atherosclerosis are increased in patients with inflammatory bowel disease (IBD). Ulcerative colitis (UC) is one type of IBD; however, there is controversy in the literature regarding the association between UC and stroke. The present cohort study estimated the risk of subsequent stroke among UC patients compared with that among matched comparison subjects drawn from a population-based data set in Taiwan.
  
  
  METHODS
  This investigation analyzed administrative claims data sourced from the Taiwan National Health Insurance Database. Our study consisted of a study cohort comprising 516 UC patients and a comparison cohort of 2,579 subjects without IBD. Cox proportional hazards regressions were performed to estimate the risk of subsequent stroke during the follow-up period. We also conducted additional analyses investigating the risk of subsequent stroke by age group and gender.
  
  
  RESULTS
  After adjusting for selected medical co-morbidities and recent prescriptions of selected pharmaceuticals, the hazard ratio (HR) for subsequent stroke among patients with UC was 2.045 (95 % confidence interval (CI) = 1.374-3.043) than that among comparison subjects. While we did not detect an association between stroke and UC among patients aged 30-40 or 40-50 years, we did detect increased risks for stroke among UC patients aged over 50 years (HR = 2.045). We also found the association to remain significant for both men (HR = 2.153) and women (HR = 2.750).
  
  
  CONCLUSIONS
  This study detected an increased HR for subsequent stroke among Taiwanese UC patients hen compared to that among matched comparison patients without IBD.
authors.affiliation: School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Keller
authors.forename: Jui
authors.initials: J
authors.lastname: Wang
authors.forename: Ya-Li
authors.initials: YL
authors.lastname: Huang
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Chou
authors.forename: Li-Hsuan
authors.initials: LH
authors.lastname: Wang
authors.forename: Jung-Lung
authors.initials: JL
authors.lastname: Hsu
authors.forename: Chyi-Huey
authors.initials: CH
authors.lastname: Bai
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chiou
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology
references.citation: Nat Clin Pract Gastroenterol Hepatol. 2005 Jun;2(6):266-72
references.pmid: 16265230
references.citation: Inflamm Bowel Dis. 2013 Dec;19(13):2815-9
references.pmid: 24141711
references.citation: Arq Neuropsiquiatr. 2010 Aug;68(4):651-2
references.pmid: 20730327
references.citation: Stroke. 2011 May;42(5):1338-44
references.pmid: 21415400
references.citation: PLoS One. 2013;8(2):e56944
references.pmid: 23457642
references.citation: Acta Gastroenterol Belg. 2009 Jul-Sep;72(3):350-3
references.pmid: 19902870
references.citation: Clin Gastroenterol Hepatol. 2008 Jan;6(1):41-5
references.pmid: 18063423
references.citation: Neurology. 2004 Feb 24;62(4):563-8
references.pmid: 14981171
references.citation: Tech Coloproctol. 2013 Oct;17(5):497-500
references.pmid: 23471541
references.citation: Biol Sex Differ. 2013 May 07;4(1):10
references.pmid: 23651648
references.citation: J Gastroenterol Hepatol. 2000 Jun;15(6):688-92
references.pmid: 10921427
references.citation: BMC Gastroenterol. 2013 Dec 06;13:166
references.pmid: 24314308
references.citation: World J Gastroenterol. 2005 Sep 14;11(34):5404-7
references.pmid: 16149158
references.citation: Am J Gastroenterol. 2009 Jun;104(6):1445-51
references.pmid: 19491858
references.citation: J Chin Med Assoc. 2012 Apr;75(4):151-5
references.pmid: 22541142
references.citation: Med J Aust. 1988 Nov 21;149(10):559-60
references.pmid: 3185327
references.citation: QJM. 2015 Mar;108(3):239-40
references.pmid: 22797968
references.citation: Eur J Gastroenterol Hepatol. 2005 Jul;17(7):697-700
references.pmid: 15947544
references.citation: Clin Gastroenterol Hepatol. 2014 Mar;12(3):382-93.e1: quiz e22
references.pmid: 23978350
references.citation: J Clin Gastroenterol. 1996 Mar;22(2):141-3
references.pmid: 8742656
references.citation: BMC Neurol. 2012 Jun 18;12:41
references.pmid: 22708578
references.citation: Inflamm Bowel Dis. 2007 Mar;13(3):254-61
references.pmid: 17206702
references.citation: J Pediatr Gastroenterol Nutr. 2007 Mar;44(3):342-6
references.pmid: 17325555
references.citation: World J Gastroenterol. 2007 Dec 14;13(46):6134-9
references.pmid: 18069751
references.citation: Int J Stroke. 2011 Dec;6(6):487-92
references.pmid: 22017824
references.citation: Gut. 2004 Apr;53(4):542-8
references.pmid: 15016749
references.citation: Eur J Gastroenterol Hepatol. 2003 Nov;15(11):1157-63
references.pmid: 14560147
references.citation: J Gastroenterol Hepatol. 2010 Mar;25(3):453-68
references.pmid: 20370724
references.citation: JAMA. 1971 Feb 8;215(6):976-7
references.pmid: 5107514
references.citation: Gastroenterol Clin North Am. 1995 Sep;24(3):633-46
references.pmid: 8809240
references.citation: Inflamm Bowel Dis. 2010 Aug;16(8):1387-92
references.pmid: 20014016
references.citation: J Clin Ultrasound. 2007 Jul-Aug;35(6):322-30
references.pmid: 17471583
references.citation: Rev Neurol. 2001 Jun 16-30;32(12):1158-62
references.pmid: 11562848
references.citation: Inflamm Bowel Dis. 2007 Apr;13(4):410-5
references.pmid: 17206678
references.citation: Obes Surg. 1999 Oct;9(5):502-5
references.pmid: 10605911
references.citation: J Gastroenterol Hepatol. 2013 Jul;28(7):1095-113
references.pmid: 23662785
references.citation: Neurologia. 2003 May;18(4):221-4
references.pmid: 12721869
references.citation: World J Gastroenterol. 2009 Feb 28;15(8):927-35
references.pmid: 19248191