Correlation between Endophthalmitis and Stroke Development in Ankylosing Spondylitis Patients: A Population-Based Cohort Study

Abstract

Background: This cohort study aimed to research the correlation between endophthalmitis and stroke development in ankylosing spondylitis (AS) patients by reviewing National Health Insurance Research Database (NHIRD) data. Methods: This study obtained data from the NHIRD over a sixteen-year period. The primary outcome was stroke development. We used Fisher’s exact test and Pearson’s chi-squared test to analyze the variables. We investigated the risk factors for disease development using Cox regression analyses. We compared the cumulative incidence of stroke using Kaplan–Meier analysis. Results: The study cohort included 549 patients with AS and endophthalmitis, while the comparison cohort included 2196 patients with AS but without endophthalmitis. The stroke development was increased in the study cohort (adjusted hazard ratio, 1.873; p ≤ 0.001). The total stroke development in the study cohort and the comparison cohort was 1724.44 per 100,000 person-years and 1085.11 per 100,000 person-years, respectively (adjusted hazard ratio, 1.873; 95% confidence interval, 1.776–2.022; p < 0.001). Our study cohort showed an increased stroke rate. Conclusions: Our studies showed that endophthalmitis increases the risk of stroke in AS patients and endophthalmitis is an independent risk factor for stroke in AS patients. Nonetheless, advanced studies that thoroughly investigate the correlation between endophthalmitis and stroke in AS patients are needed to validate our findings.