美国急性缺血性脑卒中后医学并发症的年龄和性别特异性趋势[j]神经病学，JO神经病学，FD Lippincott Williams & Wilkins SP e1282 OP e1295 DO 10.1212/WNL.0000000000206749半岛投注体育官网VO 100 IS 12 A1 Rashid Ahmed A1 Carl Mhina A1 Karan Philip A1 Smit D. Patel A1 Ehimen Aneni A1 Chukwuemeka Osondu A1 Oluwatomi Lamikanra A1 Emmanuel Oladele Akano A1 Nnabuchi Anikpezie A1 Karen C. Albright A1 Julius G. Latorre A1 Seemant Chaturvedi A1 Fadar Oliver Otite YR 2023 UL http://n.半岛投注体育官网neurology.org/content/100/12/e1282.abstract AB背景与目的验证传染性(肺炎，脓毒症，2007年至2019年，美国急性缺血性卒中(AIS)住院后，尿路感染(UTI)和非感染性(深静脉血栓形成(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))并发症增加。方法:我们使用2007-2019年全国住院患者样本进行了一系列横断面研究。使用国际疾病分类代码确定有或无并发症的成人(18岁或以上)原发性AIS入院。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来评估随时间变化的趋势。结果5751,601名加权入院患者中，51.4%为女性。25.1%至少有1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，而脓毒症(1.7%)、GIB(1.1%)、DVT(1.2%)和PE(0.5%)是最不常见的并发症。不同年龄/性别的并发症风险存在显著差异(UTI:男性18-39岁2.1%;80岁以上妇女22.5%)。2007-2019年期间，尿路感染(12.9%-9.7%)和肺炎(3.8%-2.7%)的患病率下降，但ARF的患病率增加了约3倍(4.8%-14%)(均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

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