title: High mortality in cirrhotic patients following hemorrhagic stroke.
abstract: The impact of hemorrhagic stroke (HS) on the mortality of cirrhotic patients is unknown. To evaluate the morality risk of HS in cirrhotic patients, we used the Taiwan National Health Insurance Database to evaluate cirrhotic patients with HS who were discharged between 1 January and 31 December 2007. In total, there were 321 cirrhotic patients with HS. We randomly selected 3210 cirrhotic patients without HS as a comparison group. The 30 and 90 day mortality rates were 29.6% and 43.0% in the HS group, and 9.1% and 17.7% in the comparison group, respectively (p<0.001). After Cox proportional hazard regression model adjustment of patients' sex, age, and other comorbid disorders, the hazard ratio (HR) for 90 day mortality in the HS group was 3.89 (95% confidence interval [CI] 3.20-4.71, p<0.001), compared to the comparison group. In the subgroup analysis, the HR for 90 day mortality in the subarachnoid hemorrhage and other HS groups were 7.93 (95% CI 5.23-12.0, p<0.001) and 3.51 (95% CI 2.85-4.32, p<0.001), respectively, compared to the comparison group. In conclusion, HS is associated with a very high 90 day mortality risk in cirrhotic patients, in whom subarachnoid hemorrhage can also increase the risk of mortality eight-fold.
authors.affiliation: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi County 62247, Taiwan; School of Medicine, Tzu Chi University, Hualien County, Taiwan.
authors.forename: Tsung-Hsing
authors.initials: TH
authors.lastname: Hung
authors.affiliation: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi County 62247, Taiwan; School of Medicine, Tzu Chi University, Hualien County, Taiwan.
authors.forename: Yu-Hsi
authors.initials: YH
authors.lastname: Hsieh
authors.affiliation: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi County 62247, Taiwan; School of Medicine, Tzu Chi University, Hualien County, Taiwan.
authors.forename: Kuo-Chih
authors.initials: KC
authors.lastname: Tseng
authors.affiliation: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi County 62247, Taiwan; School of Medicine, Tzu Chi University, Hualien County, Taiwan.
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Tseng
authors.affiliation: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi County 62247, Taiwan; School of Medicine, Tzu Chi University, Hualien County, Taiwan.
authors.forename: Hsing-Feng
authors.initials: HF
authors.lastname: Lee
authors.affiliation: Department of Mathematics, Tamkang University, Tamsui District, Taiwan.
authors.forename: Chih-Chun
authors.initials: CC
authors.lastname: Tsai
authors.affiliation: Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, 2 Minsheng Road, Dalin Township, Chiayi County 62247, Taiwan; School of Medicine, Tzu Chi University, Hualien County, Taiwan. Electronic address: antibody_1@msn.com.
authors.forename: Chen-Chi
authors.initials: CC
authors.lastname: Tsai
mesh_terms: D000368:Aged; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012306:Risk; D020521:Stroke / Q000150:complications* / Q000401:mortality*; D013345:Subarachnoid Hemorrhage / Q000150:complications; D013624:Taiwan
keywords: Cirrhosis; Epidemiology; Hemorrhagic stroke; Mortality; Subarachnoid hemorrhage