Increased risk of stroke among patients with Crohn’s disease: a population-based matched cohort study

• Published in: International journal of colorectal disease Vol. 30; no. 5; pp. 645 - 653
• Main Authors: Keller, Joseph Jordan, Wang, Jui, Hwang, Ya-Li, Chou, Chia-Chi, Wang, Li-Hsuan, Hsu, Jung-Lung, Bai, Chyi-Huey, Chiou, Hung-Yi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2015; Springer; Springer Nature B.V
• Subjects: Adult; Age Distribution; Aged; Analysis of Variance; Case-Control Studies; Comorbidity; Crohn Disease - diagnosis; Crohn Disease - epidemiology; Databases, Factual; Female; Gastroenterology; Gastrointestinal diseases; Hepatology; Humans; Incidence; Internal Medicine; Kaplan-Meier Estimate; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Multivariate Analysis; National health insurance; Original Article; Proctology; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk factors; Severity of Illness Index; Sex Distribution; Stroke - diagnosis; Stroke - epidemiology; Stroke patients; Surgery; Survival Rate; Taiwan - epidemiology; Taiwan; Epidemiology; Stroke; Crohn’s disease
• ISSN: 0179-1958; 1432-1262; 1432-1262
• DOI: 10.1007/s00384-015-2132-y

Background Crohn’s disease (CD) is one type of inflammatory bowel disease (IBD) that has been speculated to share prognostic factors with the development of stroke. There is controversial information in the literature regarding the association between CD and stroke. The present cohort study estimated the risk of subsequent stroke among CD patients compared with matched comparison subjects drawn from a population-based dataset in Taiwan. Method This study drew data from the Taiwan National Health Insurance Database to conduct a historical cohort study. The study cohort comprised 3309 CD patients, and the comparison cohort comprised 13,236 subjects without an IBD. Cox proportional hazards regressions were performed to estimate the risk of subsequent stroke during the follow-up period. We also conducted additional analyses stratifying by age group and gender. Results After adjusting for selected medical co-morbidities and recent prescriptions of selected pharmaceuticals, the hazard ratio (HR) for subsequent stroke among patients with CD was found to be 1.911 (95 % confidence interval (CI) = 1.65–2.22) that of comparison subjects. While we did not detect an association between stroke and CD among patients aged 30–40 years, we did detect increased risks for stroke among CD patients aged 40–50 years (HR = 2.29) and those aged over 50 years (HR = 1.88). We also found women (HR = 2.39) to be at a greater risk than men (HR = 1.50). Conclusion This study reports an increased HR for subsequent stroke among CD patients when compared to matched comparison patients without IBD in an Asian population.