預測攝護腺根除手術後中風發生的預測模式
謝登富、李祥生、陳至正、劉昕和、蔡宗訓、林殿璜
台中慈濟醫院 外科部 泌尿科 慈濟大學 醫學院
Model for predicting the risk of ischemic stroke after radical prostatectomy
Teng-Fu Hsieh, Shang-Sen Lee, Chi-Cheng Chen, Hsin-Ho Liu, Tsung-Hsun Tsai, Tien-Huang Lin
Department of Urology, Taichung Tzu Chi Hospital, Taichung and School of Medicine, Tzu Chi University, Hualian, Taiwan
Purpose:
The aim of this study is to assesses the predictive value of CHADS2 scores, CHA2DS2-VASc scores and Charlson Comorbidity Index Score (CCIS) for stroke among patients with prostate cancer.
Materials and Methods:
We used Taiwan registry data base, National Health Insurance Research Database (NHIRD) in this study. We identified participants with non- atrial fibrillation (AF) prostate cancer diagnoses who underwent radical prostatectomy between January 1,1997 and December 31,2011. CHADS2 scores, CHA2DS2-VASc scores and CCIS were used to stratify the ischemic stroke risk. The scores were calculated based on the comorbilities recorded before radical prostatectomy. The receiver operating characteristics curve (ROC) was used to assess the prediction accuracy for ischemic stroke. All participants were followed from the date of enrollment until ischemic stroke, death, or the end of the 5-year follow up period.
Results:
There were5414 patients diagnosed with prostate cancer undergoing radical prostatectomy in this study. The mean age at diagnosis was 65 ± 6 years. The prediction accuracy for ischemic stroke in better in CHADS2 scores (AUC=0.971) and CHA2DS2-VASc scores (AUC=0.953) than CCIS (AUC=0.504).
Conclusions:
Our results show that the CHADS2 score could be applied for ischemic stroke prediction in prostate cancer patients underwent radical prostatectomy. Cardiovascular risks evaluation and management are suggested for these patient with higher CHADS2 score.