The Incidence of Venous Thromboembolism in Patients with Acute Ischemic and Hemorrhagic Stroke: A Nationwide Population-Based Study in Taiwan

急性缺血性與出血性中風後靜脈栓塞之發生率：臺灣健保資料庫全國性的研究

張凱茗(Kai-Ming Jhang) ； 賴建旭(Chien-Hsu Lai) ； 王文甫(Wen-Fu Wang) ； 陳彥宇(Yen-Yu Chen)

《The Changhua Journal of Medicine》 14卷1期 (2016/03) Pp. 12-20

https://doi.org/10.6501/CJM.1401.002

摘要

目的：探討急性缺血性與出血性中風後靜脈栓塞之發生率方法：本研究利用健保資料庫2005 百萬歸人檔，該資料包含一百萬個於2005 年有參與全民健保的個案中隨機抽出的病歷資料。利用國際疾病分類第九版(ICD-9-CM)找出1999 年至2008 年間因急性缺血性與出血性中風住院，並於住院中有出現靜脈栓塞者。結果：於1999 至2008 年間，總共有9,320 次急性缺血性中風住院及3,124 次急性出血性中風住院。靜脈栓塞在急性缺血性與出血性中風的發生率分別為0.14% 及0.32%。整體而言，中風後發生靜脈栓塞的比例為0.18%。多元邏輯斯迴歸分析顯示女性、過去有靜脈栓塞病史及較長住院天數增加中風後靜脈栓塞的危險。結論：出血性中風的靜脈栓塞發生率較缺血性中風高。急性中風期靜脈栓塞的危險因子包括女性、較長住院天數及過去有靜脈栓塞病史。需要更多研究來探討不同的靜脈栓塞預防方法對臺灣急性中風病患的有效性。

關鍵字

深部靜脈栓塞 ； 肺栓塞 ； 中風 ； 靜脈血栓栓塞

並列摘要

Objective: To investigate the incidence of venous thromboembolism (VTE) among patients with acute ischemic or hemorrhagic stroke. Methods: Research data were collected from a subset of the National Health Insurance Research Database of Taiwan containing medical records of one million individuals randomly sampled from 25.68 million registered beneficiaries. Hospitalizations for acute ischemic and hemorrhagic stroke between 1999 and 2008, including cases of the complication of VTE, were selected according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Results: A total of 9,320 hospitalizations for acute ischemic stroke and 3,124 for hemorrhagic stroke were identified. The incidence of VTE was 0.14% (13 events) in cases of acute ischemic stroke and 0.32% (10 events) in cases of hemorrhagic stroke. The overall incidence of VTE after acute stroke was 0.18%. Multivariate logistic regression demonstrated that the female gender, a history of prior VTE, and the length of hospital stay were associated with an increased risk of post-stroke VTE. Conclusions: Compared with ischemic stroke, patients with hemorrhagic stroke tended to have a higher incidence of VTE. The risk factors for VTE during the acute stroke period included the female gender, length of hospital stay and a history of VTE. The effectiveness of VTE prophylaxis in Taiwanese patients using different methods warrants further study.

並列關鍵字

deep vein thrombosis ； pulmonary embolism ； stroke ； venous thromboembolism