| Summary: | 碩士 === 國立中山大學 === 企業管理學系研究所 === 103 === Abstract
Stroke is a severe illness and it causes loss of life, medical burden, and lost of productivity. Bipolar disorder is one kind of mental disorder and induces clinically occupational, social, interpersonal dysfunction.
The study aimed to evaluate the prognosis about bipolar patients had received surgical interventions for stroke. And also offer strategies for physicians to treat bipolar patients with stroke.
In the study, 25,481 bipolar patients from National Health Insurance Research Database (NHIRD) between 1999 and 2005. 101,924 age- and sex- matched control participants not have diagnosis of bipolar disorder. Both groups excluded participants had stroke from 1999 to 2005. Surgical procedures for stroke included Craniectomy or Craniotomy, Clipping, Coiling, Embolization of carotid-cavernous fistula, EC-IC bypass, Carotid Endarterectomy, Carotid Angioplasty and Stenting. Patient survival after surgical procedure was evaluated from 2006 to 2010.
The five-year stroke-free survival rate and mortality rate were estimated by Cox proportional-hazards model after adjusting for confounding risk factor.
683(2.7 %) bipolar patients and 2100(2.1%) controls had stroke. 131(0.5%) bipolar patients and 410(0.4%) controls had received surgical procedure for stroke. Bipolar patients had higher rate of stroke and surgical treatment before adjusted confounding factors.
But five year survival rate was not significantly different between two groups (Log Rank = 0.287). After adjusted for variables, the mortality for bipolar patient had received surgical procedure was not significantly different from those did not have bipolar disorder.
We found bipolar patient had higher risk for stroke. The result of the study suggested that patients should receive surgical procedure if indicated.
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