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Stroke risk among adult patients with third, fourth or sixth cranial nerve palsy: a Nationwide Cohort Study

Authors
 Tyler Hyungtaek Rim  ;  Jinu Han  ;  Yoon Seong Choi  ;  Taekjune Lee  ;  Sung Soo Kim 
Citation
 Acta Ophthalmologica, Vol.95(7) : e656-e661, 2017 
Journal Title
 Acta Ophthalmologica 
ISSN
 1755-375X 
Issue Date
2017
MeSH
Abducens Nerve Diseases/complications* ; Adult ; Aged ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Oculomotor Nerve Diseases/complications* ; Propensity Score* ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Assessment* ; Risk Factors ; Stroke/epidemiology* ; Stroke/etiology ; Time Factors ; Trochlear Nerve Diseases/complications*
Keywords
cranial nerve palsy ; fourth nerve palsy ; sixth nerve palsy ; stroke ; third nerve palsy
Abstract
PURPOSE: This study sought to determine whether isolated third, fourth and sixth cranial nerve palsies (NPs) are associated with increased short- and long-term risk of a subsequent stroke. METHODS: This was a nationwide retrospective propensity score-matched cohort study. A cohort of patients with NP (n = 466) and a randomly selected, propensity-matched control cohort (n = 2281) were extracted from the Korean national insurance claim database. Subjects were tracked for 5 years total, subdivided into periods of 0-1 years, 1-3 years and 3-5 years. We assessed the risk of stroke using hazard ratios (HRs) and confidence intervals (CIs) after adjustments using Cox regression at different time intervals. RESULTS: The median follow-up was 3.1 years. Stroke developed in 18.9% of the NP cohort and 7.5% of the control cohort. Stroke risk after NP was highest in the first year [14.7 per 100 person-year at 0-1 years (HR = 6.6), 3.1 per 100 person-year at 1-3 years (HR = 1.6) and 4.3 per 100 person-year at 3-5 years (HR = 2.8)]. Each type of NP was also associated with stroke risk: within 0-1 years, stroke risk was increased in third (HR = 7.6), fourth (HR = 6.0) and sixth (HR = 5. 84) NPs. In the 3- to 5-year period, risk was increased in sixth (HR = 4.7) and fourth (HR = 3.3) NPs, but not third (HR = 0.6) NPs. CONCLUSION: Patients in the NP cohort were more likely to have a stroke than those in the matched control cohort; the increased risk was both time- and cranial nerve-dependent.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1111/aos.13488
DOI
10.1111/aos.13488
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김성수(Kim, Sung Soo) ORCID logo https://orcid.org/0000-0002-0574-7993
이택준(Lee, Taek June)
임형택(Rim, Tyler Hyungtaek)
최윤성(Choi, Yoon Seong)
한진우(Han, Jinu) ORCID logo https://orcid.org/0000-0002-8607-6625
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/161345
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