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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Intracerebral Hemorrhage in Multiple Sclerosis: A Retrospective Cohort Study
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Intracerebral Hemorrhage in Multiple Sclerosis: A Retrospective Cohort Study

机译：多发性硬化中的脑出血：回顾性队列研究

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Background: To identify the vascular risk factors associated with the occurrence of intracerebral hemorrhage (ICH) in Multiple Sclerosis (MS) patients. Methods: This is an observational, retrospective cohort study using the nationwide electronic medical records (EMR) database. Patients with the diagnosis of MS were extracted from inpatient and outpatient EMR using the international classification of diseases, ninth/tenth revisions, clinical modification codes. We excluded patients younger than 18 years, and those where gender was not specified. Patients were further stratified based on their demographics, risk factors, medications, and comorbidities. Tobacco, diabetes, hypertension, and alcohol were the predicting variables; antiplatelet medication, and anticoagulant agents were the primary exposures for the development of ICH. A validated diagnosis code algorithm defined the diagnosis of ICH. Multivariable logistic regression models were utilized to assess the risk of ICH in MS patients. Results: Of the total 57,099 MS patients (women: 75%, n = 41,517), 107 (.19%) sustained an ICH. Age (OR = 2.74, CI = 1.13-6.62), use of anticoagulants (OR = 2.15, 95% CI = 1.30-3.56, P = .0028), and history of tobacco exposure (OR = 2.44, CI =1.37-4.36, P = .0025) were associated with increased risk of ICH. Use of antiplatelet and disease-modifying drugs (DMDs) showed a protective trend against ICH. Conclusions: Tobacco exposure and anticoagulant use were strongly associated with increased risk of ICH in patients with MS. There might be a protective effect that antiplatelet and DMDs have in the pathophysiology of this disease. Further prospective investigations are warranted to establish these associations.
机译：背景：鉴定与多发性硬化症（MS）患者中脑出血（ICH）发生相关的血管危险因素。方法：这是一种观察，回顾性队列研究，使用全国电子医疗记录（EMR）数据库。使用国际疾病分类，第九/第十修订，临床修改规范，从住院和门诊EMR提取诊断患者。我们被排除在18岁以下的患者，并且未指定性别的患者。患者进一步基于其人口统计，危险因素，药物和合并症分层分层。烟草，糖尿病，高血压和酒精是预测变量;抗血小板药物和抗凝血剂是ICH发育的主要曝光。经过验证的诊断码算法定义了ICH的诊断。利用多变量逻辑回归模型来评估MS患者中ICH的风险。结果：总计57,099例患者（女性：75％，N = 41,517），107（.19％）持续一个ICH。年龄（或= 2.74，CI = 1.13-6.62），使用抗凝血剂（或= 2.15,95％CI = 1.30-3.56，P = .0028），以及烟草暴露的历史（或= 2.44，CI = 1.37-4.36 ，p = .0025）与ICH的风险增加有关。使用抗血小板和疾病改性药物（DMDS）对ICH表现出保护趋势。结论：烟草暴露和抗凝血用途与MS患者患者的风险增加强烈关联。抗血小板和DMDS可能存在这种疾病的病理生理学可能存在保护作用。需要进一步的预期调查，以建立这些协会。

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