Influenza-like illness as a trigger for ischemic stroke
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Open Access
- 31 March 2018
- journal article
- research article
- Published by Wiley in Annals of Clinical and Translational Neurology
- Vol. 5 (4), 456-463
- https://doi.org/10.1002/acn3.545
Abstract
ObjectiveWe hypothesized that ILI is associated with risk of incident stroke, and that the risk would be highest closest in time to the event. MethodsThis case-crossover analysis utilized data obtained from the California State Inpatient Database of the Healthcare Cost and Utilization Project (HCUP). The outcome of interest was ischemic stroke. Exposure was defined as a visit to the emergency department or hospitalization for influenza-like illness (ILI) 365, 180, 90, 30, or 15 days before stroke (risk period) or similar time intervals exactly 1 or 2 years before stroke (control period). Conditional logistic regression was used to calculate the odds ratio and 95% confidence interval (OR, 95% CI). ResultsIn 2009, 36,975 hospitalized ischemic strokes met inclusion criteria, and of these strokes, 554 (1.5%) had at least 1 episode of ILI in the 365-day risk period prior to their stroke. Using non-overlapping time intervals from ILI to stroke, the odds of ischemic stroke was greatest in the first 15 days post ILI (OR: 2.88, 95% CI: 1.86-4.47). The strength of the relationship decreased as the time from ILI increased, and was no longer significant after 60 days. There was a significant interaction (P = 0.017) with age and ILI; the odds of stroke associated increased 7% with each 10-year decrease in age (OR per 10-year age decrease 1.07, 95% CI: 1.03-1.35). InterpretationWe found that ILI increases short-term risk of stroke, particularly in people under the age of 45, and therefore may be considered to act as a trigger for stroke.Keywords
Funding Information
- National Institute of Neurological Disorders and Stroke (L30 NS093600, T32 NS007153-31)
- National Institute on Minority Health and Health Disparities (R21 MD012451)
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