Risk and Outcome of Stroke in Patients with Liver Cirrhosis: Two Nationwide Studies = Risk and Outcome of Stroke in Patients with Liver Cirrhosis: Two Nationwide Studies

다국어 초록 (Multilingual Abstract)

Aims: The association between liver cirrhosis (LC) and stroke was not completely understood. The purpose of this study is to evaluate stroke risk and post-stroke outcomes in patients with LC. Methods: Using the Taiwan National Health Insurance Research Database, we identified 6944 adults aged ≥20 years diagnosed with LC in 2000-2005. Non-LC cohort consisted of 27776 adults randomly selected and matched by age and sex (case-control ratio=1:4). Incident events of stroke occurring after LC from January 1, 2000, through the end of 2009 were identified in the follow-up period. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke associated with LC were calculated. We conducted another nested cohort study consisted of 21267 patients with hospitalization due to stroke between January 1, 2004, and December 31, 2010. We calculated the adjusted odds ratios (ORs) and 95% CIs of 30-day mortality after stroke in patients with and without LC during admission. Results: The incidences of stroke for people with and without LC were 7.5 and 4.9 per1000 person-years, respectively (P<0.0001). Compared to people without LC, patients with LC had increased risk of stroke (HR 1.75, 95% CI 1.52-2.01). The association was significant in both sexes. In the nested cohort study, LC was associated with post-hemorrhage mortality (OR 1.83, 95% CI 1.63-2.05) and epilepsy (OR 1.30, 95% CI 1.09-1.56). Conclusions: Patients with LC showed higher risks of stroke and post-stroke mortality. Our findings suggest the urgency of preventing and managing LC by a multidisciplinary medical team for this specific population.