Effect of COPD on the Hospital Outcomes and Mortality among Hemorrhagic Stroke Patients. Sex Differences in a Population-Based Study

Abstract

(1) Background: It is not well known whether there is an association between COPD and hemorrhagic stroke (HS). We aim to analyze the incidence, clinical characteristics, procedures, and outcomes of HS in patients with and without COPD and to assess sex differences. Secondly, to identify factors associated with in-hospital mortality (IHM). (2) Methods: Patients aged ≥40 years hospitalized with HS included in the Spanish National Hospital Discharge Database (2016–2018) were analyzed. Propensity score matching (PSM) was used to compare patients according to sex and COPD status. (3) Results: We included 55,615 patients (44.29% women). Among men with COPD the HS adjusted incidence was higher (IRR 1.31; 95% CI 1.24–1.57) than among non-COPD men. COPD men had higher adjusted incidence of HS than COPD women (IRR 1.87; 95% CI 1.85–1.89). After matching, COPD men had a higher IHM (29.96% vs. 27.46%; p = 0.032) than non-COPD men. Decompressive craniectomy was more frequently conducted among COPD men than COPD women (6.74% vs. 4.54%; p = 0.014). IHM increased with age and atrial fibrillation, while decompressive craniectomy reduced IHM. (4) Conclusions: COPD men had higher incidence and IHM of HS than men without COPD. COPD men had higher incidence of HS than COPD women. Decompressive craniectomy was more frequently conducted in COPD men than COPD women and this procedure was associated to better survival.

Impact of potent nucleos(t)ide therapy on hepatitis B hospitalisations in Spain

“…Prior studies have been performed on this registry for other illnesses, including infectious diseases. They have recognised its high value for producing estimates of current burden and time trends for different clinical conditions at the national level 12–15 . Given that the Spanish health system provides universal coverage, even for illegal migrants, biases due to difficulties in access to care should be negligible.…”

Stroke risk of COPD patients and death risk of COPD patients following a stroke: A systematic review and meta-analysis

“…When the COPD-stroke mortality correlation was divided into short-term and long-term, we found that the evidence for the correlation of COPD effects on the short-term risk of death in stroke was not very strong, Studies by Lekoubou and Ovbiagele, [10] Szylińska et al, [9] and de Miguel-Diez et al [16] did not support this correlation, and they concluded that COPD has a limited effect on early stroke mortality. In contrast, COPD appears to have a progressive effect on stroke mortality as time prolongs.…”

“…Of the 27 included papers, 14 reported the risk of stroke in combination with COPD, [3,5,[16][17][18][19][20][21][22][23][24][25] 6 reported the risk of stroke in combination with AECOPD. [19,[26][27][28][29][30] The risk of death after stroke was reported in 12 articles.…”

“…[19,[26][27][28][29][30] The risk of death after stroke was reported in 12 articles. [8][9][10]16,26,[31][32][33][34][35][36][37] Most studies of stroke risk in COPD adjusted for risk factors such as age, sex, and comorbidities, and only 2 studies had single-factor regression analysis data. [17,38] Four studies provided separate data on the risk of ischemic stroke, [17][18][19][20] and 4 studies provided separate risk data for hemorrhagic stroke.…”

“…[17,38] Four studies provided separate data on the risk of ischemic stroke, [17][18][19][20] and 4 studies provided separate risk data for hemorrhagic stroke. [16,[18][19][20] All but two of these studies [16,36] provided all the data on the risk of stroke.…”