Bacterial Pneumonia and Stroke Risk: A Nationwide Longitudinal Followup Study

Title:Bacterial Pneumonia and Stroke Risk: A Nationwide Longitudinal Followup Study

Volume: 20 Issue: 5

Author(s): Joyce En-Hua Wang, Shih-Jen Tsai, Yen-Po Wang, Tzeng-Ji Chen, Tso-Jen Wang*Mu-Hong Chen*

Affiliation:

• Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, 33058, Taiwan

• Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
• Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
• Institute of Brain Science, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

Keywords: Bacterial pneumonia, stroke, cohort study, cardiovascular complications, clinical management, infectious etiology.

Abstract: Background: Pneumonia causes significant morbidity and mortality and has been associated with cardiovascular complications. Our study aimed to investigate the incidence of ischemic and hemorrhagic strokes following bacterial pneumonia.

Methods: Between 1997 and 2012, 10,931 subjects with bacterial pneumonia and 109,310 controls were enrolled from the Taiwan National Health Insurance Research Database, and were followed up to the end of 2013. The risk of stroke was estimated in Cox regression analyses with hazard ratios (HRs) and 95% confidence intervals (CIs).

Results: When compared to the control group, subjects in the bacterial pneumonia group had a higher incidence of developing ischemic stroke (2.7% versus 0.4%, p <0.001) and hemorrhagic stroke (0.7% versus 0.1%, p <0.001). The risk of stroke increases with repeated hospitalizations due to bacterial pneumonia. Across bacterial etiologies, bacterial pneumonia was a significant risk factor among 775 subjects who developed ischemic stroke (HR, 5.72; 95% CI, 4.92-6.65) and 193 subjects who developed hemorrhagic stroke (HR, 5.33; 95% CI, 3.91-7.26).

Conclusion: The risks of developing ischemic stroke and hemorrhagic stroke are significant following bacterial pneumonia infection. The risk factors, clinical outcomes, and the disease course should also be profiled to better inform the monitoring of stroke development and the clinical management of bacterial pneumonia patients.

Cite this article as:

Wang En-Hua Joyce, Tsai Shih-Jen, Wang Yen-Po, Chen Tzeng-Ji, Wang Tso-Jen*, Chen Mu-Hong*, Bacterial Pneumonia and Stroke Risk: A Nationwide Longitudinal Followup Study, Current Neurovascular Research 2023; 20 (5) . https://dx.doi.org/10.2174/0115672026280736240108093755