Increased Risk of Hemorrhagic and Ischemic Strokes in Patients With Splenic Injury and Splenectomy: A Nationwide Cohort Study.
The spleen is a crucial organ in humans. Little is known about the association between stroke and splenic injury or splenectomy. The aim of this study was to determine the risk of stroke in patients with splenic injury and splenectomy.A nationwide cohort study was conducted by analyzing the National Health Insurance Research Database in Taiwan. For comparison, control patients were selected and matched with splenic injury patients in a ratio of 4:1 according to age, sex, and the year of hospitalization. We analyzed the risks of stroke using a Cox proportional-hazards regression analysis.A total of 11,273 splenic injury patients, including 5294 splenectomized and 5979 nonsplenectomized patients, and 45,092 control patients were included in this study. The incidence rates of stroke were 8.05, 6.53, and 4.25 per 1000 person-years in splenic injury patients with splenectomy, those without splenectomy, and the control cohort, respectively. Compared with the control cohort, splenic injury patients with splenectomy exhibited a 2.05-fold increased risk of stroke (95% confidence interval [CI] 1.8-2.34), whereas those without splenectomy exhibited a 1.74-fold increased risk (95% CI 1.51-2). Splenectomy entailed an additional 1.21-fold increased risk of stroke compared with nonsplenectomy in patients with splenic injury.This study revealed that splenic injury and splenectomy were significantly associated with an increased risk of hemorrhagic and ischemic strokes. The results of this study may alert physicians and patients to the complications of splenic injury and splenectomy.
From the Department of Critical Care Medicine (J-NL); Department of Internal Medicine, Division of Infectious Diseases (J-NL, C-HL, H-HL), Department of Nuclear Medicine (M-CL); E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; School of Medicine (J-NL); College of Medicine, I-Shou University, Kaohsiung, Taiwan; Management Office for Health Data (C-LL); Department of Nuclear Medicine and PET Center (C-HK); China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine (C-HK); College of Medicine (C-LL); China Medical University, Taichung, Taiwan; and General Education Center (C-HY), and Meiho University, Pingtung, Taiwan.
Jiun-Nong
JN
Lin
Cheng-Li
CL
Lin
Ming-Chia
MC
Lin
Chung-Hsu
CH
Lai
Hsi-Hsun
HH
Lin
Chih-Hui
CH
Yang
Chia-Hung
CH
Kao
D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000453:epidemiology; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000453:epidemiology; D015331:Cohort Studies; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013154:Spleen / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy / Q000009:adverse effects*; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*; D013624:Taiwan / Q000453:epidemiology