Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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Association between ischemic stroke and pyogenic spondylitis in Korea: Nationwide longitudinal cohort study

  • Soo Hyun Lee (Department of Neurosurgery, CHA University, CHA Bundang Medical Center) ;
  • Hakyung Kim (Genome & Health Big Data Branch, Department of Public Health, Graduate School of Public Health, Seoul National University) ;
  • In-bo Han (Department of Neurosurgery, CHA University, CHA Bundang Medical Center) ;
  • Seung Hun Sheen (Department of Neurosurgery, CHA University, CHA Bundang Medical Center) ;
  • Je Beom Hong (Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine) ;
  • Seil Sohn (Department of Neurosurgery, CHA University, CHA Bundang Medical Center)
  • Received : 2022.09.06
  • Accepted : 2022.12.31
  • Published : 2023.06.30
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Abstract

Objective: The purpose of this nationwide age- and sex- matched longitudinal study was to determine the pyogenic spondylitis (PS) increases the incidence of ischemic stroke (IS) in Korea. Methods: From the National Health Insurance Service (NHIS), we collected the patient data for the period from January 1, 2004 to December 31, 2015. PS was classified according to the International Classification of Disease codes M46.2-M46.8, M49.2, and M49.3. By using a 1:5 age- and sex- stratified matching, a total of 628 patients and 3140 control subjects were included in the study. The IS incidence rates in PS and control group was calculated by using the Kaplan-Meier method. The outcome of hazard ratio of IS was estimated by Cox proportional hazards regression analyses. This study did not exclude PS as a result of postoperative complications. Results: According to the study, 51 patients (8.12%) in the PS group and 201 patients (6.4%) in the control group experienced IS. The adjusted hazard ratio of IS in the PS group was 3.419 (95% CI: 2.473-4.729) after adjusting individual medical condition and demographics. Following the results of subgroup analysis, the risk ratio of IS was greater in most of the subgroup categories (male, female, age <65, age >65, non-diabetic, hypertensive, non-hypertensive, dyslipidemic and non-dyslipidemic subgroup). However, the risk of IS did not differ significantly in diabetic subgroup (95% CI: 0.953-4.360). Conclusions: The risk rate of IS increased in patient with pyogenic spondylitis.

Keywords

Acknowledgement

This work was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2020R1I1A1A01072258). This work was also supported by a grant of Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and future Planning (NRF-2020R1F1A1069875).

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