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Incidence of stroke and stroke subtypes in chronic obstructive pulmonary disease.

Söderholm, Martin LU ; Inghammar, Malin LU ; Hedblad, Bo LU ; Egesten, Arne LU and Engström, Gunnar LU (2016) In European Journal of Epidemiology 31(2). p.159-168
Abstract
It is uncertain whether the incidence of stroke is increased in patients with chronic obstructive pulmonary disease (COPD), and whether COPD is associated with all subtypes of stroke (i.e. ischemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage). We evaluated the association between COPD and incidence of stroke in a nation-wide cohort study. All individuals between 40 and 84 years of age, hospitalised for COPD between 1987 and 2003 in Sweden were identified in the Swedish hospital discharge register. For each COPD patient (n = 103,419), one reference individual was randomly selected from the general population matched for year of birth, sex and county of residence. After excluding subjects with prior stroke, incidence rates... (More)
It is uncertain whether the incidence of stroke is increased in patients with chronic obstructive pulmonary disease (COPD), and whether COPD is associated with all subtypes of stroke (i.e. ischemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage). We evaluated the association between COPD and incidence of stroke in a nation-wide cohort study. All individuals between 40 and 84 years of age, hospitalised for COPD between 1987 and 2003 in Sweden were identified in the Swedish hospital discharge register. For each COPD patient (n = 103,419), one reference individual was randomly selected from the general population matched for year of birth, sex and county of residence. After excluding subjects with prior stroke, incidence rates during 10 years follow-up were calculated. Hazard ratios (HR) for stroke comparing COPD patients with reference subjects were estimated using Cox regression adjusting for demographics and comorbidities. Incidence of all-cause stroke (n events = 17,402) was significantly increased in COPD patients compared to reference individuals (HR 1.24, 95 % CI 1.19-1.28), especially during the first 2 years after COPD diagnosis (HR 1.46, 1.37-1.55). Incidences of ischemic stroke (HR 1.20, 1.15-1.25), intracerebral haemorrhage (HR 1.29, 1.16-1.43) and subarachnoid haemorrhage (HR 1.46, 1.16-1.85) were all increased in COPD patients. Incidences of all stroke subtypes are increased in COPD, especially during the first years after COPD diagnosis. The association was independent of several comorbidities, although residual confounding from smoking and hypertension cannot be excluded. A global evaluation of stroke risk factors seems warranted in patients with COPD. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Epidemiology
volume
31
issue
2
pages
159 - 168
publisher
Springer
external identifiers
  • pmid:26711630
  • scopus:84951940932
  • wos:000373568800006
ISSN
1573-7284
DOI
10.1007/s10654-015-0113-7
language
English
LU publication?
yes
id
a384f931-cef3-4591-9c79-17cf0d71a9bc (old id 8500311)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26711630?dopt=Abstract
date added to LUP
2016-01-06 19:52:47
date last changed
2017-11-12 04:06:12
@article{a384f931-cef3-4591-9c79-17cf0d71a9bc,
  abstract     = {It is uncertain whether the incidence of stroke is increased in patients with chronic obstructive pulmonary disease (COPD), and whether COPD is associated with all subtypes of stroke (i.e. ischemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage). We evaluated the association between COPD and incidence of stroke in a nation-wide cohort study. All individuals between 40 and 84 years of age, hospitalised for COPD between 1987 and 2003 in Sweden were identified in the Swedish hospital discharge register. For each COPD patient (n = 103,419), one reference individual was randomly selected from the general population matched for year of birth, sex and county of residence. After excluding subjects with prior stroke, incidence rates during 10 years follow-up were calculated. Hazard ratios (HR) for stroke comparing COPD patients with reference subjects were estimated using Cox regression adjusting for demographics and comorbidities. Incidence of all-cause stroke (n events = 17,402) was significantly increased in COPD patients compared to reference individuals (HR 1.24, 95 % CI 1.19-1.28), especially during the first 2 years after COPD diagnosis (HR 1.46, 1.37-1.55). Incidences of ischemic stroke (HR 1.20, 1.15-1.25), intracerebral haemorrhage (HR 1.29, 1.16-1.43) and subarachnoid haemorrhage (HR 1.46, 1.16-1.85) were all increased in COPD patients. Incidences of all stroke subtypes are increased in COPD, especially during the first years after COPD diagnosis. The association was independent of several comorbidities, although residual confounding from smoking and hypertension cannot be excluded. A global evaluation of stroke risk factors seems warranted in patients with COPD.},
  author       = {Söderholm, Martin and Inghammar, Malin and Hedblad, Bo and Egesten, Arne and Engström, Gunnar},
  issn         = {1573-7284},
  language     = {eng},
  number       = {2},
  pages        = {159--168},
  publisher    = {Springer},
  series       = {European Journal of Epidemiology},
  title        = {Incidence of stroke and stroke subtypes in chronic obstructive pulmonary disease.},
  url          = {http://dx.doi.org/10.1007/s10654-015-0113-7},
  volume       = {31},
  year         = {2016},
}