The incidence and relative risk of stroke among patients with bipolar disorder: a seven-year follow-up study

• Published in: PloS one 2013-08, Vol.8 (8), p.e73037-e73037
• Main Authors: Wu, Hung-Chi, Chou, Frank Huang-Chih, Tsai, Kuan-Yi, Su, Chao-Yueh, Shen, Shih-Pei, Chung, Tieh-Chi
• Format: Article
• Language: English
• Subjects: Adult; Biology; Bipolar disorder; Bipolar Disorder - complications; Bipolar Disorder - epidemiology; Case-Control Studies; Comorbidity; Demographics; Demography; Diabetes; Female; Follow-Up Studies; Hazards; Health insurance; Health risks; Humans; Identification methods; Incidence; Male; Medicine; Mortality; Patients; Physicians; Population studies; Proportional Hazards Models; Risk analysis; Risk Factors; Stroke; Stroke - epidemiology; Stroke - etiology; Studies; Survival; Taiwan - epidemiology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0073037

This study aimed to estimate the incidence and relative risk of stroke and post-stroke all-cause mortality among patients with bipolar disorder. This study identified a study population from the National Health Insurance Research Database (NHIRD) between 1999 and 2003 that included 16,821 patients with bipolar disorder and 67,284 age- and sex-matched control participants without bipolar disorder. The participants who had experienced a stroke between 1999 and 2003 were excluded and were randomly selected from the NHIRD. The incidence of stroke (ICD-9-CM code 430-438) and patient survival after stroke were calculated for both groups using data from the NIHRD between 2004 and 2010. A Cox proportional-hazards model was used to compare the seven-year stroke-free survival rate and all-cause mortality rate across the two cohorts after adjusting for confounding risk factors. A total of 472 (2.81%) patients with bipolar disorder and 1,443 (2.14%) controls had strokes over seven years. Patients with bipolar disorder were 1.24 times more likely to have a stroke (95% CI = 1.12-1.38; p