So Young Kim1, Jae-Sung Lim2, Songyong Sim3, Hyo Geun Choi4. 1. Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam. 2. Department of Neurology, Hallym University Sacred Heart Hospital, Anyang. 3. Department of Statistics, Hallym University, Chuncheon. 4. Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Korea.
Abstract
OBJECTIVES: To investigate the risk of stroke in SSNHL patients. STUDY DESIGN: A longitudinal follow-up cohort study. SETTING: The Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013. PATIENTS: The 4,944 SSNHL participants were matched with 19,776 controls for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia. The SSNHL subjects were diagnosed (International Classification of Disease [ICD]-10: H91.2), underwent an audiometry examination, and were treated with steroids. The history of hemorrhagic stroke, ischemic stroke, hypertension, diabetes, dyslipidemia, ischemic heart disease, and depression was investigated based on the ICD-10. MAIN OUTCOME MEASURES: The hazard ratios (HRs) for hemorrhagic and ischemic stroke were analyzed using a Cox proportional hazard model. Subgroup analyses were conducted according to age (< 50 vs. ≥ 50 yr old) and sex. RESULTS: Participants diagnosed with ischemic stroke included 4.2% of SSNHL subjects and 3.5% of control subjects (p = 0.013). The adjusted HR of SSNHL for ischemic stroke was 1.22 (95% confidence interval [95% CI] = 1.05 - 1.43, p = 0.012). The ≥ 50-year-old male SSNHL subgroup showed 1.40 adjusted HRs for ischemic stroke (95% CI = 1.10 - 1.78, p = 0.006). The rate of hemorrhagic stroke was 0.7% for SSNHL and 0.6% for control subjects. SSNHL did not elevate the risk of hemorrhagic stroke (p = 0.310). CONCLUSION: SSNHL elevated the risk of ischemic stroke in the general population. Older males with SSNHL demonstrated a high risk for ischemic stroke; however, SSNHL did not increase the risk of hemorrhagic stroke.
OBJECTIVES: To investigate the risk of stroke in SSNHLpatients. STUDY DESIGN: A longitudinal follow-up cohort study. SETTING: The Korean National Health Insurance Service-National Sample Cohort from 2002 to 2013. PATIENTS: The 4,944 SSNHLparticipants were matched with 19,776 controls for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia. The SSNHL subjects were diagnosed (International Classification of Disease [ICD]-10: H91.2), underwent an audiometry examination, and were treated with steroids. The history of hemorrhagic stroke, ischemic stroke, hypertension, diabetes, dyslipidemia, ischemic heart disease, and depression was investigated based on the ICD-10. MAIN OUTCOME MEASURES: The hazard ratios (HRs) for hemorrhagic and ischemic stroke were analyzed using a Cox proportional hazard model. Subgroup analyses were conducted according to age (< 50 vs. ≥ 50 yr old) and sex. RESULTS:Participants diagnosed with ischemic stroke included 4.2% of SSNHL subjects and 3.5% of control subjects (p = 0.013). The adjusted HR of SSNHL for ischemic stroke was 1.22 (95% confidence interval [95% CI] = 1.05 - 1.43, p = 0.012). The ≥ 50-year-old male SSNHL subgroup showed 1.40 adjusted HRs for ischemic stroke (95% CI = 1.10 - 1.78, p = 0.006). The rate of hemorrhagic stroke was 0.7% for SSNHL and 0.6% for control subjects. SSNHL did not elevate the risk of hemorrhagic stroke (p = 0.310). CONCLUSION:SSNHL elevated the risk of ischemic stroke in the general population. Older males with SSNHL demonstrated a high risk for ischemic stroke; however, SSNHL did not increase the risk of hemorrhagic stroke.