Risk of mortality and recurrence after first-time stroke among patients with type 2 diabetes: A Danish nationwide cohort study.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2024-06-14 DOI:10.1177/23969873241260956

Frederik Pagh Bredahl Kristensen, Helene Matilde Lundsgaard Svane, Kristina Laugesen, Sofie Kejlberg Al-Mashhadi, Diana Hedevang Christensen, Henrik Toft Sørensen, Nils Skajaa

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引用次数: 0

Abstract

Introduction: The prognosis for stroke patients with type 2 diabetes mellitus (T2DM) remains poorly understood. We examined the risk of mortality and stroke recurrence in stroke patients with T2DM and stroke patients without diabetes.

Patients and methods: We conducted a population-based cohort study including all patients diagnosed with a first-time ischemic stroke (n = 131,594) or intracerebral hemorrhage (ICH, n = 15,492) in Denmark, 2005-2021. Patients with T2DM were identified using hospital diagnosis codes and glucose-lowering drug prescriptions. We calculated risks, risk differences, and risk ratios, standardized by age, sex, and calendar year of stroke admission.

Results: Following ischemic stroke, the 5-year standardized mortality was 46.1% for patients with T2DM and 35.4% for patients without diabetes (standardized risk difference: 10.7% [95% CI 9.9-11.6]; risk ratio: 1.3 [95% CI 1.3-1.3]). The 5-year risk of recurrence following ischemic stroke was 12.7% for patients with T2DM and 11.3% for those without diabetes (risk difference: 1.4% [95% CI 0.9-2.0]; risk ratio: 1.1 [95% CI 1.1-1.2]). Following ICH, the 5-year mortality was 62.8% for patients with T2DM and 53.0% for patients without diabetes (risk difference: 9.8% [95% CI 7.2-12.4)]; risk ratio: 1.2 [95% CI 1.1-1.2]). The 5-year risk of recurrence after ICH was 9.1% for patients with T2DM and 9.7% for patients without diabetes.

Discussion and conclusion: Stroke patients with T2DM were at increased risk of mortality. The risk of stroke recurrence was slightly higher for ischemic stroke patients with T2DM than patients without diabetes, while no difference was observed among ICH patients.

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2 型糖尿病患者首次中风后的死亡和复发风险：一项丹麦全国性队列研究。

简介对患有 2 型糖尿病（T2DM）的卒中患者的预后仍然知之甚少。我们研究了患有 T2DM 的脑卒中患者和未患有糖尿病的脑卒中患者的死亡率和脑卒中复发风险：我们开展了一项基于人群的队列研究，研究对象包括 2005-2021 年期间在丹麦确诊为首次缺血性中风（n = 131,594 例）或脑内出血（ICH，n = 15,492 例）的所有患者。我们通过医院诊断代码和降糖药物处方确定了 T2DM 患者。我们计算了风险、风险差异和风险比，并按年龄、性别和中风入院日历年进行了标准化：结果：缺血性脑卒中发生后，T2DM 患者的 5 年标准化死亡率为 46.1%，非糖尿病患者为 35.4%（标准化风险差异为 10.7% [95% C]）：10.7% [95% CI 9.9-11.6]；风险比：1.3 [95% CI 1.3-1.3]）。T2DM 患者缺血性卒中后的 5 年复发风险为 12.7%，非糖尿病患者为 11.3%（风险差异：1.4% [95% CI 0.9-2.0]；风险比：1.1 [95% CI 1.1-1.2]）。发生 ICH 后，T2DM 患者的 5 年死亡率为 62.8%，非糖尿病患者为 53.0%（风险差异：9.8% [95% CI 7.2-12.4]；风险比：1.2 [95% CI 1.1-1.2]）。T2DM患者ICH后5年复发风险为9.1%，非糖尿病患者为9.7%：讨论与结论：T2DM 患者的死亡风险增加。T2DM患者的卒中复发风险略高于非糖尿病患者，而在ICH患者中未观察到差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.