The incidence and relative risk of stroke in patients with schizophrenia: A five-year follow-up study

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• 作者：Kuan-Yi Tsai^a ; Ching-Chih Lee^b ; ^c ; ^d ; Yu-Mei Chou^e ; Chao-Yueh Su^f ; Frank Huang-Chih Chou^a ; ^g ; ^{f50911.tw@yahoo.com.tw}
• 关键词：Stroke incidence ; Schizophrenia ; National Health Insurance Research Database (NHIRD)
• 刊名：Schizophrenia Research
• 出版年：2012
• 期刊代码：240_09209964
• 类别：med
• 出版时间：June, 2012
• 卷：138
• 期：1
• 页码：41-47
• 文件大小：204 K

摘要

Objective

This study aimed to estimate the incidence and relative risk of stroke and post-stroke all-cause mortality in patients with schizophrenia.

Methods

This study identified a study population from the National Health Insurance Research Database (NHIRD) between 1999 and 2003 that included 80,569 patients with schizophrenia and 241,707 age- and sex-matched control participants without schizophrenia. The participants were randomly selected from the 23,981,020-participant NHIRD, which consists of 96%Taiwanese participants. Participants who had experienced a stroke between 1999 and 2003 were excluded. Using data from the NHIRD between 2004 and 2008, the incidence of stroke (ICD-9-CM code 430-438) and patient survival after stroke were calculated for both groups. After adjusting for confounding risk factors, a Cox proportional-hazards model was used to compare the five-year stroke-free survival rate to the all-cause mortality rate across the two cohorts.

Results

Over five years, 1380 (1.71%) patients with schizophrenia and 2954 (1.22%) controls suffered from strokes. After adjusting for demographic characteristics and comorbid medical conditions, patients with schizophrenia were 1.13 times more likely to have a stroke (95%CI = 1.05-1.22; P = 0.0006). In addition, 1039 (24%) patients who had a stroke died during the follow-up period. After adjusting for patient, physician and hospital variables, the all-cause mortality hazard ratio for patients with schizophrenia was 1.23 (95%CI = 1.06-1.41; P = 0.0052).

Conclusions

During a five-year follow-up, the likelihood of developing a stroke and the all-cause mortality rate were greater among patients with schizophrenia as compared with the control group.