TY - JOUR T1 -美国急性缺血性中风后医疗并发症的年龄和性别特异性趋势JF - Neurology JO - Neurology SP - e1282 LP - e1295 DO - 10.1212/WNL.00000000002067半岛投注体育官网49六世- 100 - 12非盟-拉希德·艾哈迈德AU -卡尔Mhina盟卡兰菲利普AU - Smit d . Patel盟Ehimen Aneni AU - Chukwuemeka Osondu盟Oluwatomi Lamikanra AU - Emmanuel Oladele,非盟赤野光信案件Nnabuchi Anikpezie盟——卡伦·c·奥尔布赖特AU -朱利叶斯·g·Latorre盟Seemant Chaturvedi盟Fadar奥利弗Otite Y1 - 2023/03/21 UR - //www.ebmtp.com/content/100/12/e1282.abstract N2 -背景和目标来测试假设的年龄和性别患病率感染(肺半岛投注体育官网炎、脓毒症、尿路感染[UTI])和非传染性(深静脉血栓[DVT]、肺栓塞[PE]、急性肾功能衰竭[ARF]、急性心肌梗死[AMI]和胃肠道出血[GIB])并发症在2007年至2019年期间在美国急性缺血性卒中(AIS)住院后增加。方法采用2007-2019年全国住院患者样本进行了连续横断面研究。采用国际疾病分类编码对伴有或不伴有并发症的成人(18岁或以上)原发性AIS入院患者进行识别。我们量化了并发症的年龄/性别特异性患病率，并使用负二项回归模型评估随时间变化的趋势。结果在5751601例加权入院患者中，51.4%为女性。25.1%至少有一种并发症。UTI(11.8%)、ARF(10.1%)、肺炎(3.2%)和AMI(2.5%)是最常见的并发症，而败血症(1.7%)、GIB(1.1%)、DVT(1.2%)和PE(0.5%)是最不常见的并发症。并发症风险在年龄/性别上存在显著差异(UTI:男性18-39岁2.1%;80岁及以上的女性22.5%)。在2007-2019年期间，UTI(12.9%-9.7%)和肺炎(3.8%-2.7%)的患病率下降，但ARF的患病率增加了≈3倍(4.8%-14%)(所有p < 0.001). AMI (1.9%–3.1%), DVT (1.0%–1.4%), and PE (0.3%–0.8%) prevalence also increased (p < 0.001), but that of sepsis and GIB remained unchanged over time. After multivariable adjustment, risk of all complications increased with increasing NIH Stroke Scale (pneumonia: prevalence rate ratio [PRR] 1.03, 95% CI 1.03–1.04, for each unit increase), but IV thrombolysis was associated with a reduced risk of all complications (pneumonia: PRR 0.80, 85% CI 0.73–0.88; AMI: PRR 0.85, 95% CI 0.78–0.92; and DVT PRR 0.87, 95% CI 0.78–0.98). Mechanical thrombectomy was associated with a reduced risk of UTI, sepsis, and ARF, but DVT and PE were more prevalent in MT hospitalizations compared with those without. All complications except UTI were associated with an increased risk of in-hospital mortality (sepsis: PRR 1.97, 95% CI 1.78–2.19).Discussion Infectious complications declined, but noninfectious complications increased after AIS admissions in the United States in the last decade. Utilization of IV thrombolysis is associated with a reduced risk of all complications.AIS=acute ischemic stroke; AMI=acute myocardial infarction; ARF=acute renal failure; CKD=chronic kidney disease; DVT=deep venous thrombosis; GIB=gastrointestinal bleeding; HCUP=Healthcare Cost and Utilization Project; ICD-9=International Classification of Diseases, 9th Revision; ICD-10=International Classification of Diseases, 10th Revision; ICH=intracerebral hemorrhage; MT=mechanical thrombectomy; MV=mechanically ventilated; NIHSS=NIH Stroke Scale; NIS=Nationwide Inpatient Sample; PE=pulmonary embolism; PRR=prevalence rate ratio; UTI=urinary tract infection ER -