The 4 Week Incidence, Timing And Predictors Of Ischemic Stroke After Trauma
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Background and purpose: To quantify the 4-week incidence, timing and predictors of ischemic stroke after trauma in a population-based young cohort.
Methods: We electronically identified trauma patients ( 30 days apart could be considered independent. As a secondary analysis, we calculated stroke incidence including all cases with a stroke ICD-9 code in order to provide a useful comparison with studies using ICD-9 stroke diagnoses for the outcome. For trauma patients who suffered a stroke, we graphically demonstrated time to stroke after trauma using Kaplan-Meier failure curves, with trauma as the time of origin and stroke as the failure event, right-censoring at death or four weeks after trauma.
For the case control study, we used logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI) as an estimate of stroke risk. In order to determine whether stroke risk varied differentially by location of injury, we first examined each location individually. We then modeled the association between stroke and each injury location with adjustment for age, race, sex and multisystem trauma (given that the composite multisystem trauma variable does not specify injury location).
Results: From a population of 34 million enrolled in KPNC over the 15-year study period, we identified 989,333 patients who had 1,308,009 emergency department encounters or admissions to the hospital for trauma. Patients contributed a median of one trauma encounter (interquartile range