Chickenpox and risk of stroke: a self-controlled case series analysis. Thomas, S. L., Minassian, C., Ganesan, V., Langan, S. M., & Smeeth, L. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 58(1):61–68, January, 2014. doi abstract bibtex BACKGROUND: There is good evidence that respiratory and other infections that cause systemic inflammation can trigger strokes; however, the role of specific infections is unclear. Case reports have highlighted chickenpox as a possible risk factor for arterial ischemic stroke, particularly in children, but rigorous studies are needed to determine and quantify any increased risk. METHODS: We used anonymized electronic health records totaling \textgreater100 million person-years of observation from 4 UK primary care databases to identify individuals who had documented clinical chickenpox and a stroke or transient ischemic attack (TIA). Self-controlled case series methods were used to quantify any increased risk of first stroke or TIA in the 0-6 and 7-12 months following chickenpox compared to other observed time periods. We analyzed data within each database, and performed meta-analyses to obtain summary age-adjusted incidence ratios (IRs) separately for adults and children. RESULTS: Five hundred sixty eligible individuals (including 60 children) were identified who experienced chickenpox and a stroke or TIA during follow-up. Among children, there was a 4-fold increased risk of stroke in the 0-6 months after chickenpox (summary IR = 4.07; 95% confidence interval [CI], 1.96-8.45; I(2) = 0%). Among adults, there was a less marked increased risk with moderate between-database heterogeneity (random-effects summary IR = 2.13; 95% CI, 1.05-4.36; I(2) = 51%). There was no significant increased risk of stroke in the 7-12 months after chickenpox in children or adults, nor was there evidence of increased risk of TIA in either time period. CONCLUSIONS: Our study provides new evidence that children who experience chickenpox are at increased risk of stroke in the subsequent 6 months.
@article{thomas_chickenpox_2014,
title = {Chickenpox and risk of stroke: a self-controlled case series analysis},
volume = {58},
issn = {1537-6591},
shorttitle = {Chickenpox and risk of stroke},
doi = {10.1093/cid/cit659},
abstract = {BACKGROUND: There is good evidence that respiratory and other infections that cause systemic inflammation can trigger strokes; however, the role of specific infections is unclear. Case reports have highlighted chickenpox as a possible risk factor for arterial ischemic stroke, particularly in children, but rigorous studies are needed to determine and quantify any increased risk.
METHODS: We used anonymized electronic health records totaling {\textgreater}100 million person-years of observation from 4 UK primary care databases to identify individuals who had documented clinical chickenpox and a stroke or transient ischemic attack (TIA). Self-controlled case series methods were used to quantify any increased risk of first stroke or TIA in the 0-6 and 7-12 months following chickenpox compared to other observed time periods. We analyzed data within each database, and performed meta-analyses to obtain summary age-adjusted incidence ratios (IRs) separately for adults and children.
RESULTS: Five hundred sixty eligible individuals (including 60 children) were identified who experienced chickenpox and a stroke or TIA during follow-up. Among children, there was a 4-fold increased risk of stroke in the 0-6 months after chickenpox (summary IR = 4.07; 95\% confidence interval [CI], 1.96-8.45; I(2) = 0\%). Among adults, there was a less marked increased risk with moderate between-database heterogeneity (random-effects summary IR = 2.13; 95\% CI, 1.05-4.36; I(2) = 51\%). There was no significant increased risk of stroke in the 7-12 months after chickenpox in children or adults, nor was there evidence of increased risk of TIA in either time period.
CONCLUSIONS: Our study provides new evidence that children who experience chickenpox are at increased risk of stroke in the subsequent 6 months.},
language = {eng},
number = {1},
journal = {Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America},
author = {Thomas, Sara L. and Minassian, Caroline and Ganesan, Vijeya and Langan, Sinéad M. and Smeeth, Liam},
month = jan,
year = {2014},
pmid = {24092802},
pmcid = {PMC3864501},
pages = {61--68},
}
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Case reports have highlighted chickenpox as a possible risk factor for arterial ischemic stroke, particularly in children, but rigorous studies are needed to determine and quantify any increased risk. METHODS: We used anonymized electronic health records totaling \\textgreater100 million person-years of observation from 4 UK primary care databases to identify individuals who had documented clinical chickenpox and a stroke or transient ischemic attack (TIA). Self-controlled case series methods were used to quantify any increased risk of first stroke or TIA in the 0-6 and 7-12 months following chickenpox compared to other observed time periods. We analyzed data within each database, and performed meta-analyses to obtain summary age-adjusted incidence ratios (IRs) separately for adults and children. RESULTS: Five hundred sixty eligible individuals (including 60 children) were identified who experienced chickenpox and a stroke or TIA during follow-up. Among children, there was a 4-fold increased risk of stroke in the 0-6 months after chickenpox (summary IR = 4.07; 95% confidence interval [CI], 1.96-8.45; I(2) = 0%). Among adults, there was a less marked increased risk with moderate between-database heterogeneity (random-effects summary IR = 2.13; 95% CI, 1.05-4.36; I(2) = 51%). There was no significant increased risk of stroke in the 7-12 months after chickenpox in children or adults, nor was there evidence of increased risk of TIA in either time period. CONCLUSIONS: Our study provides new evidence that children who experience chickenpox are at increased risk of stroke in the subsequent 6 months.","language":"eng","number":"1","journal":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","author":[{"propositions":[],"lastnames":["Thomas"],"firstnames":["Sara","L."],"suffixes":[]},{"propositions":[],"lastnames":["Minassian"],"firstnames":["Caroline"],"suffixes":[]},{"propositions":[],"lastnames":["Ganesan"],"firstnames":["Vijeya"],"suffixes":[]},{"propositions":[],"lastnames":["Langan"],"firstnames":["Sinéad","M."],"suffixes":[]},{"propositions":[],"lastnames":["Smeeth"],"firstnames":["Liam"],"suffixes":[]}],"month":"January","year":"2014","pmid":"24092802","pmcid":"PMC3864501","pages":"61–68","bibtex":"@article{thomas_chickenpox_2014,\n\ttitle = {Chickenpox and risk of stroke: a self-controlled case series analysis},\n\tvolume = {58},\n\tissn = {1537-6591},\n\tshorttitle = {Chickenpox and risk of stroke},\n\tdoi = {10.1093/cid/cit659},\n\tabstract = {BACKGROUND: There is good evidence that respiratory and other infections that cause systemic inflammation can trigger strokes; however, the role of specific infections is unclear. Case reports have highlighted chickenpox as a possible risk factor for arterial ischemic stroke, particularly in children, but rigorous studies are needed to determine and quantify any increased risk.\nMETHODS: We used anonymized electronic health records totaling {\\textgreater}100 million person-years of observation from 4 UK primary care databases to identify individuals who had documented clinical chickenpox and a stroke or transient ischemic attack (TIA). Self-controlled case series methods were used to quantify any increased risk of first stroke or TIA in the 0-6 and 7-12 months following chickenpox compared to other observed time periods. We analyzed data within each database, and performed meta-analyses to obtain summary age-adjusted incidence ratios (IRs) separately for adults and children.\nRESULTS: Five hundred sixty eligible individuals (including 60 children) were identified who experienced chickenpox and a stroke or TIA during follow-up. Among children, there was a 4-fold increased risk of stroke in the 0-6 months after chickenpox (summary IR = 4.07; 95\\% confidence interval [CI], 1.96-8.45; I(2) = 0\\%). Among adults, there was a less marked increased risk with moderate between-database heterogeneity (random-effects summary IR = 2.13; 95\\% CI, 1.05-4.36; I(2) = 51\\%). There was no significant increased risk of stroke in the 7-12 months after chickenpox in children or adults, nor was there evidence of increased risk of TIA in either time period.\nCONCLUSIONS: Our study provides new evidence that children who experience chickenpox are at increased risk of stroke in the subsequent 6 months.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America},\n\tauthor = {Thomas, Sara L. and Minassian, Caroline and Ganesan, Vijeya and Langan, Sinéad M. and Smeeth, Liam},\n\tmonth = jan,\n\tyear = {2014},\n\tpmid = {24092802},\n\tpmcid = {PMC3864501},\n\tpages = {61--68},\n}\n\n","author_short":["Thomas, S. L.","Minassian, C.","Ganesan, V.","Langan, S. 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