A Comprehensive Assessment of Vascular and Nonvascular Risk Factors Associated with Migraine.
| Autor: | Patel UK; Neurology and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA., Shah D; Clinical Research, Icahn School of Medicine at Mount Sinai, New York, USA., Malik P; Pediatrics, The Children's Hospital at Montefiore, Bronx, USA., Hussain M; Public Health, Icahn School of Medicine at Mount Sinai, New York, USA., Chauhan B; Public Health, Long Island University, New York, USA., Patel D; Public Health, New York Medical College, School of Health Science and Practice, Valhalla, USA., Sharma S; Internal Medicine, SUNY Downstate Medical Center, Brooklyn, USA., Khan N; Internal Medicine, Multicare Tacoma General Hospital, Tacoma, USA., Patel K; Nursing, Holy Family University, School of Nursing, Philadelphia, USA., Kapoor A; Neurology, Bayonne Medical Center‑ Carepoint Health & Jersey City Medical Center‑ RWJ Barnabas Health, Jersey City, USA., Kavi T; Neurology, Cooper Neurological Institute, Cooper University Hospital, Camden, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2019 Nov 18; Vol. 11 (11), pp. e6189. Date of Electronic Publication: 2019 Nov 18. |
| DOI: | 10.7759/cureus.6189 |
| Abstrakt: | Introduction: Migraine is a chronic disabling neurological disease, with an estimated expense of $15-20 million/year. Several studies with a small number of patients have studied risk factors for migraine such as cardiovascular disorders, stroke, smoking, demographic, and genetic factors but this is the first comprehensive study for evaluation of vascular and nonvascular risk factors. It is important to evaluate all the risk factors that help to prevent the healthcare burden related to migraine. Methodology: We performed a retrospective cross-sectional analysis of the Nationwide Inpatient Sample (NIS) (years 2013-2014) in adult (>18-years old) hospitalizations in the United States. Migraine patients were identified using ICD-9-CM code to determine the demographic characteristics, vascular, and nonvascular risk factors. Univariate analysis was performed using the chi-square test and a multivariate survey logistic regression analysis was performed to identify the prevalence of the risk factors and evaluate the odds of prevalence of risk factors amongst migraine patients compared to nonmigraine patients, respectively. Results: On weighted analysis, after removing missing data of age, gender and race, from years 2013 to 2014, of the total 983,065 (1.74%) migraine patients were identified. We found that younger (median age 48-years vs. 60-years), female (82.1% vs. 58.5%; p<0.0001), white population (76.8% vs. 70.5%; p<0.0001), and privately insured (41.1% vs. 27.4%; p<0.0001) patients were more likely to have migraine than others. Cerebral atherosclerosis, diabetes mellitus, ischemic heart disease, atrial fibrillation, and alcohol abuse were not significantly associated with migraine. Migraineurs had higher odds of having hypertension [odds ratio (OR): 1.44; 95% confidence interval (CI): 1.43-1.46; 44.49% vs. 52.84%], recent transient ischemic attack (TIA) (OR: 3.13; 95%CI: 3.02-3.25; 1.74% vs. 0.67%), ischemic stroke (OR: 1.40; 95%CI: 1.35-1.45; 2.06% vs. 1.97%), hemorrhagic stroke (OR: 1.11; 95%CI: 1.04-1.19; 0.49% vs. 0.46%), obesity (OR: 1.46; 95%CI: 1.44-1.48; 19.20% vs. 13.56%), hypercholesterolemia (OR: 1.33; 95%CI: 1.30-1.36; 5.75% vs. 5.54%), substance abuse (OR: 1.51; 95%CI: 1.48-1.54; 7.88% vs. 4.88%), past or current consumption of tobacco (OR: 1.40; 95%CI: 1.38-1.41; 31.02% vs. 27.39%), AIDS (OR: 1.13; 95%CI: 1.04-1.24; 0.33% vs. 0.41%), hypocalcemia (OR: 1.09; 95%CI: 1.03-1.14; 0.77% vs. 0.89%), and vitamin D deficiency (OR: 1.93; 95%CI: 1.88-1.99; 2.47% vs. 1.37%) than patients without migraine. Female patients were at a higher risk of migraine (OR: 3.02; 95%CI: 2.98-3.05) than male. Conclusion: In this study, we have identified significant risk factors for migraine hospitalizations. Early identification of these risk factors may improve the risk stratification in migraine patients. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2019, Patel et al.) |
| Databáze: | MEDLINE |
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