title: Increased Risk of Post-Trauma Stroke after Traumatic Brain Injury-Induced Acute Respiratory Distress Syndrome.
abstract: This study determines whether acute respiratory distress syndrome (ARDS) is an independent risk factor for an increased risk of post-traumatic brain injury (TBI) stroke during 3-month, 1-year, and 5-year follow-ups, respectively, after adjusting for other covariates. Clinical data for the analysis were from the National Health Insurance Database 2000, which covered a total of 2121 TBI patients and 101 patients with a diagnosis of TBI complicated with ARDS (TBI-ARDS) hospitalized between January 1, 2001 and December 31, 2005. Each patient was tracked for 5 years to record stroke occurrences after discharge from the hospital. The prognostic value of TBI-ARDS was evaluated using a multivariate Cox proportional hazard model. The main outcome found that stroke occurred in nearly 40% of patients with TBI-ARDS, and the hazard ratio for post-TBI stroke increased fourfold during the 5-year follow-up period after adjusting for other covariates. The increased risk of hemorrhagic stroke in the ARDS group was considerably higher than in the TBI-only cohort. This is the first study to report that post-traumatic ARDS yielded an approximate fourfold increased risk of stroke in TBI-only patients. We suggest intensive and appropriate medical management and intensive follow-up of TBI-ARDS patients during the beginning of the hospital discharge.
authors.affiliation: 1 Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University , Taipei, Taiwan .|6 Orthodontic and Pedodontic Division, Tri-Service General Hospital (TSGH), National Defense Medical Center (NDMC), Neihu District, Taipei, Taiwan .
authors.forename: Gunng-Shinng
authors.initials: GS
authors.lastname: Chen
authors.affiliation: 2 Department of Neurosurgery, Wan Fang Hospital, Taipei Medical University , Taipei, Taiwan .
authors.forename: Kuo-Hsing
authors.initials: KH
authors.lastname: Liao
authors.affiliation: 3 School of Respiratory Therapy, College of Medicine, Division of Pulmonary Medicine, Department of Internal Medicine, Taipei Medical University Hospital and Wan Fang Hospital, Taipei Medical University , Taipei, Taiwan .
authors.forename: Mauo-Ying
authors.initials: MY
authors.lastname: Bien
authors.affiliation: 4 Department of Neurology, Tri-Service General Hospital (TSGH), National Defense Medical Center (NDMC), Neihu District, Taipei, Taiwan .
authors.forename: Giia-Sheun
authors.initials: GS
authors.lastname: Peng
authors.affiliation: 1 Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University , Taipei, Taiwan .|5 Department of Physiology, School of Medicine, College of Medicine, Taipei Medical University , Taipei, Taiwan .
authors.forename: Jia-Yi
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020300:Intracranial Hemorrhages / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: 5-year follow-up; acute respiratory distress syndrome; population-based cohort study; post-trauma stroke; traumatic brain injury