I-Kuan Wang1, Chung-Hsiang Liu2, Tzung-Hai Yen3, Jiann-Shing Jeng4, Shih-Pin Hsu5, Chih-Hung Chen6, Li-Ming Lien7, Ruey-Tay Lin8, An-Chih Chen9, Huey-Juan Lin10, Hsin-Yi Chi11, Ta-Chang Lai12, Yu Sun13, Siu-Pak Lee14, Sheng-Feng Sung15, Po-Lin Chen16, Jiunn-Tay Lee17, Tsuey-Ru Chiang18, Shinn-Kuang Lin19, Chih-Hsin Muo20, Henry Ma21, Chi-Pang Wen22, Fung-Chang Sung23, Chung Y Hsu24. 1. Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan. 2. Departmemt of Neurology, China Medical University Hospital, Taichung, Taiwan. 3. Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan. 4. Neurology, National Taiwan University Hospital, Taipei, Taiwan. 5. Department of Neurology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan. 6. Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Stroke Center, National Cheng Kung University Hospital, Tainan, Taiwan. 7. Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital and Taipei Medical University College of Medicine, Taipei, Taiwan. 8. Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 9. Department Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan. 10. Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan. 11. Show Chwan Memorial Hospital, Changhua. Taiwan. 12. Cheng Hsin General Hospital, Taipei, Taiwan. 13. En Chu Kong Hospital, New Taipei City, Taiwan. 14. Department of Neurology, Far Eastern Memorial Hospital, Taipei, Taiwan. 15. Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan. 16. Taichung Veterans General Hospital, Taichung, Taiwan. 17. Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 18. Cathay General Hospital, Taipei, Taiwan. 19. Taipei Tzuchi Hospital, New Taipei City, Taiwan. 20. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 21. Monash University, Melbourne, Victoria, Australia. 22. Institute of Population Science, National Health Research Institute, Zhunan, Taiwan. 23. Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. Electronic address: fcsung1008@yahoo.com. 24. Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Departmemt of Neurology, China Medical University Hospital, Taichung, Taiwan.
Abstract
BACKGROUND: We investigated the impact of serum cholesterol levels on 30-day mortality after ischemic stroke in dialysis patients. METHODS: From the Taiwan Stroke Registry data, we identified 46,770 ischemic stroke cases, including 1101 dialysis patients and 45,669 nondialysis patients from 2006 to 2013. RESULTS: Overall, the 30-day mortality was 1.46-fold greater in the dialysis group than in the nondialysis group (1.75 versus 1.20 per 1000 person-days). The mortality rates were 1.64, .62, 2.82, and 2.23 per 1000 person-days in dialysis patients with serum total cholesterol levels of <120 mg/dL, 120-159 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively. Compared to dialysis patients with serum total cholesterol levels of 120-159 mg/dL, the corresponding adjusted hazard ratios of mortality were 4.20 (95% confidence interval [CI] = 1.01-17.4), 8.06 (95% CI = 2.02-32.2), and 6.89 (95% CI = 1.59-29.8) for those with cholesterol levels of <120 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively. CONCLUSIONS: Dialysis patients with serum total cholesterol levels of ≥160 mg/dL or <120 mg/dL on admission are at an elevated hazard of 30-day mortality after ischemic stroke.
BACKGROUND: We investigated the impact of serum cholesterol levels on 30-day mortality after ischemic stroke in dialysis patients. METHODS: From the Taiwan Stroke Registry data, we identified 46,770 ischemic stroke cases, including 1101 dialysis patients and 45,669 nondialysis patients from 2006 to 2013. RESULTS: Overall, the 30-day mortality was 1.46-fold greater in the dialysis group than in the nondialysis group (1.75 versus 1.20 per 1000 person-days). The mortality rates were 1.64, .62, 2.82, and 2.23 per 1000 person-days in dialysis patients with serum total cholesterol levels of <120 mg/dL, 120-159 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively. Compared to dialysis patients with serum total cholesterol levels of 120-159 mg/dL, the corresponding adjusted hazard ratios of mortality were 4.20 (95% confidence interval [CI] = 1.01-17.4), 8.06 (95% CI = 2.02-32.2), and 6.89 (95% CI = 1.59-29.8) for those with cholesterol levels of <120 mg/dL, 160-199 mg/dL, and ≥200 mg/dL, respectively. CONCLUSIONS: Dialysis patients with serum total cholesterol levels of ≥160 mg/dL or <120 mg/dL on admission are at an elevated hazard of 30-day mortality after ischemic stroke.