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CMAJ. 2018 Mar 12;190(10):E285-E290. doi: 10.1503/cmaj.170994.

Risk of stroke in patients with dengue fever: a population-based cohort study.

Author information

1
Department of Radiology (Li), E-Da Hospital; Department of Radiology (Huang), Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan; Management Office for Health Data (Su) and Department of Nuclear Medicine and PET Center (Kao), China Medical University Hospital; College of Medicine (Su) and Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine (Kao), China Medical University; Department of Bioinformatics and Medical Engineering (Kao), Asia University, Taichung, Taiwan.
2
Department of Radiology (Li), E-Da Hospital; Department of Radiology (Huang), Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung, Taiwan; Management Office for Health Data (Su) and Department of Nuclear Medicine and PET Center (Kao), China Medical University Hospital; College of Medicine (Su) and Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine (Kao), China Medical University; Department of Bioinformatics and Medical Engineering (Kao), Asia University, Taichung, Taiwan d10040@mail.cmuh.org.tw.

Abstract

BACKGROUND:

Stroke is a severe neurologic complication of dengue fever, described in only a few case reports. The incidence and risk factors for stroke in patients with dengue remain unclear. We conducted a population-based retrospective cohort study to investigate the risk of stroke in patients with dengue.

METHODS:

Using data from the Taiwan National Health Insurance Research Database, we included a total of 13 787 patients with dengue newly diagnosed between 2000 and 2012. The control cohort consisted of patients who did not have dengue, matched 1:1 by demographic characteristics and stroke-related comorbidities. We calculated the cumulative incidences and hazard ratios (HRs) of stroke in both cohorts using Kaplan-Meier curves and Cox proportional hazards regression.

RESULTS:

The overall incidence rate of stroke was 5.33 per 1000 person-years in the dengue cohort and 3.72 per 1000 person-years in the control cohort, with an adjusted HR of 1.16 (95% confidence interval [CI] 1.01-1.32). The risk of stroke among patients with dengue was highest in the first 2 months after diagnosis (25.53 per 1000 person-years, adjusted HR 2.49, 95% CI 1.48-4.18).

INTERPRETATION:

Dengue fever was associated with an increased risk of stroke in the first few months after diagnosis. The effect of dengue on stroke may be acute rather than chronic.

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