ArticleJournal of neurology2026
Spinal cord injuries & disorders as a risk factor for ischemic stroke: a five-year retrospective cohort study of US Veterans.
Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundSpinal cord injuries and disorders (SCI/D) have been reported by some studies to correlate with increased risk of ischemic cerebral stroke. However, the reports are sparse, conflicting, generally lacked SCI/D-specific analysis, and commonly had small sample sizes.
objectiveTo determine whether SCI/D are a risk factor for ischemic stroke and evaluate for underlying SCI/D-related stroke risk correlations.
methodsUsing a retrospective design aimed to capture a large sample with SCI/D, first-ever stroke incidence was estimated by Poisson regression models for US Veterans with and without SCI/D during fiscal years 2017-2021 using US Veterans Health Administration and Medicare utilization data. Models were adjusted for Veteran characteristics, common stroke risk factors, and prescriptions for stroke-prophylactic medications.
resultsAnalyses included 560,314 Veterans, including 12,450 with SCI/D. Adjusting for person-days, age, sex, smoking, diabetes, hypertension, atrial fibrillation, race, ethnicity, and stroke-prophylactic medications, Veterans with SCI/D had a 19% higher stroke incidence compared to controls [incidence rate ratio (IRR) 1.19, 95%CI: 1.11-1.28]. Compared to controls, stroke incidence was 50% and 31% higher with high and low tetraplegia, respectively [IRR 1.50, 95%CI: 1.17-1.92 and IRR 1.31, 95%CI: 1.02-1.67], and markedly higher for younger Veterans with SCI/D (ages < 40 years) [IRR 2.25, 95%CI: 1.24-4.08]. Relative to controls, stroke incidence was 36% higher with non-traumatic SCI/D [IRR 1.36, 95%CI: 1.24-1.49], but not with traumatic spinal cord injury [IRR 1.05, 95%CI: 0.95-1.17].
conclusionSCI/D are a risk factor for ischemic stroke in US Veterans, especially for Veterans with tetraplegia, non-traumatic SCI/D, and younger age.
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