Cheng-Yu Wei1,2,3, Shu-Hung Chuang4,5, Cheng-Li Lin6, Woon-Man Kung3, Hsu Chih Tai3, Kevin Wen-Kai Tsai1, Chia-Hung Kao7,8,9, Chien-Hua Chen10, Yung-Hsiang Yeh10, Chung Y Hsu11. 1. Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan. 2. Department of Neurology, Show Chwan Memorial Hospital, Changhua, Taiwan. 3. Department of Exercise and Health Promotion, College of Education, Chinese Culture University, Taipei, Taiwan. 4. Division of General Surgery, Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan. 5. IRCAD-AITS Show Chwan Health Care System, Changhua, Taiwan. 6. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. 7. Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan. 8. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. 9. Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan. 10. Digestive Disease Center, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan. 11. Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
Abstract
BACKGROUND AND AIM: Gallstones and stroke are common diseases worldwide. The relationship between gallstones and stroke has been documented in the literature. In this work, to characterize the risk of stroke among gallstone patients with and without cholecystectomy, we investigated the effects of cholecystectomy in a nationwide population-based retrospective cohort study. METHODS: Data were obtained from Taiwan's National Health Insurance Research Database. The study comprised 155 356 gallstone patients divided into two groups: those with and without cholecystectomy. RESULTS: During the study period (2000-2012), 19 096 (17.8/1000 person-years) gallstone patients without cholecystectomy and 11 913 (10.6/1000 person-years) gallstone patients with cholecystectomy had a stroke. Following gallstone removal, the patients exhibited a significant decrease in the risk of overall stroke (hazard ratio [HR] = 0.60, 95% confidence interval [CI] = 0.59-0.61), ischemic stroke (HR = 0.59, 95% CI = 0.58-0.61), and hemorrhagic stroke (HR = 0.56, 95% CI = 0.53-0.59). Asymptomatic and symptomatic gallstone patients had lower overall stroke risk after cholecystectomy (HR = 0.64, 95% CI = 0.62-0.67 and HR = 0.57, 95% CI = 0.56-0.59) than did asymptomatic gallstone patients without cholecystectomy. CONCLUSIONS: This population-based cohort study demonstrated that cholecystectomy is related to reduce the risk of overall stroke, ischemic stroke, and hemorrhagic stroke. Preventive measures for stroke may be considered for gallstone patients, particularly those presenting risk factor(s) for stroke.
BACKGROUND AND AIM: Gallstones and stroke are common diseases worldwide. The relationship between gallstones and stroke has been documented in the literature. In this work, to characterize the risk of stroke among gallstonepatients with and without cholecystectomy, we investigated the effects of cholecystectomy in a nationwide population-based retrospective cohort study. METHODS: Data were obtained from Taiwan's National Health Insurance Research Database. The study comprised 155 356 gallstonepatients divided into two groups: those with and without cholecystectomy. RESULTS: During the study period (2000-2012), 19 096 (17.8/1000 person-years) gallstonepatients without cholecystectomy and 11 913 (10.6/1000 person-years) gallstonepatients with cholecystectomy had a stroke. Following gallstone removal, the patients exhibited a significant decrease in the risk of overall stroke (hazard ratio [HR] = 0.60, 95% confidence interval [CI] = 0.59-0.61), ischemic stroke (HR = 0.59, 95% CI = 0.58-0.61), and hemorrhagic stroke (HR = 0.56, 95% CI = 0.53-0.59). Asymptomatic and symptomatic gallstonepatients had lower overall stroke risk after cholecystectomy (HR = 0.64, 95% CI = 0.62-0.67 and HR = 0.57, 95% CI = 0.56-0.59) than did asymptomatic gallstonepatients without cholecystectomy. CONCLUSIONS: This population-based cohort study demonstrated that cholecystectomy is related to reduce the risk of overall stroke, ischemic stroke, and hemorrhagic stroke. Preventive measures for stroke may be considered for gallstonepatients, particularly those presenting risk factor(s) for stroke.
Authors: Ruoxiang Wang; Nicholas N Nissen; Yi Zhang; Chen Shao; Chia-Yi Chu; Carissa Huynh; Edwin M Posadas; James S Tomlinson; Michael S Lewis; Stephen J Pandol Journal: Front Physiol Date: 2022-02-14 Impact factor: 4.566