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. 2018 Mar 1;13(3):e0193886.
doi: 10.1371/journal.pone.0193886. eCollection 2018.

Chronic rhinosinusitis increases the risk of hemorrhagic and ischemic stroke: A longitudinal follow-up study using a national sample cohort

Woo Hyun Lee  1 , Jeong-Whun Kim  2 , Jae-Sung Lim  3 , Il Gyu Kong  4 , Hyo Geun Choi  4
Affiliations

Chronic rhinosinusitis increases the risk of hemorrhagic and ischemic stroke: A longitudinal follow-up study using a national sample cohort

Woo Hyun Lee et al. PLoS One. .

Abstract

Background: Several studies have reported that chronic rhinosinusitis (CRS) increases the risk of stroke. The aim of this study is to elucidate the putative association between CRS and stroke (ischemic or hemorrhagic) using large population-based national health insurance data.

Methods: Using the national cohort study from the Korean Health Insurance Review and Assessment Service, CRS patients (n = 22,959) and control participants (n = 91,836) were selected and matched at a rate of 1:4 (age, sex, income, region, hypertension, diabetes, and dyslipidemia). A Cox-proportional hazard model was used to analyze the hazard ratio (HR) of CRS for hemorrhagic stroke and ischemic stroke. We divided the participants according to age and gender for the subgroup analysis.

Results: The HR for hemorrhagic and ischemic stroke was significantly increased in the CRS patients compared to that in the controls (adjusted HR = 2.43, 95% confidence interval [CI] = 2.10-2.80 for hemorrhagic stroke; adjusted HR = 1.76, 95% CI = 1.61-1.92 for ischemic stroke) after adjusting for age, sex, income, region of residence, hypertension, diabetes, dyslipidemia, ischemic heart disease, migraine, chronic kidney disease, depression, sleep disorder, and chronic obstructive pulmonary disorder. In the subgroup analysis, the HR of hemorrhagic stroke was significantly increased in the CRS group regardless of age and gender. The HR of ischemic stroke was also significantly increased in all subgroups of the CRS group.

Conclusion: CRS consistently increased the risk of ischemic and hemorrhagic stroke regardless of age and gender.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. A schematic illustration of the participant selection process that was used in the present study.
Of 1,125,691 cases with 114,369,638 medical claim codes, 34,572 CRS participants were selected. The participants of previous stroke history were excluded (n = 540). The CRS participants were matched 1:4 with a control group who had not been diagnosed with CRS. Un-matched CRS participants (n = 119) and less than 20 years old participants (n = 10,954) were excluded. Finally, 22,959 CRS participants and 91,836 control participants were included.
See this image and copyright information in PMC

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