Stroke risk increased in COPD with previous exacerbation

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  • Patients with COPD with previous exacerbation (COPDe) had higher risk for stroke and poorer poststroke outcomes.

Why this matters

  • Patients with COPDe may warrant additional monitoring and stroke prevention strategies.

Key results

  • Incidence of stroke was higher in patients with COPDe than those without COPD (7.6 vs 5.8 per 1000 person-years; P<.0001). 
  • Stroke risk was not increased in patients with COPD without exacerbation (COPDne). 
  • Association between COPDe and stroke risk was significant in males (HR, 1.37) and patients aged 50-69 y (HR, 1.44). 
  • Probability of stroke at 1, 5, and 10 y postexacerbation was 1%, 4%, and 8%, respectively. Compared with those without COPD, probability of stroke was increased in COPDe (P<.0001), but not in patients with COPDne. 
  • Patients with COPDe had higher risk for poststroke mortality (OR, 1.34), epilepsy (OR, 1.43), and pneumonia (OR, 1.50) compared with those without COPD.

Study design

  • Retrospective cohort study of 1918 patients with COPDe, 3836 with COPDne, and 7672 without COPD. 
  • Funding: Shuang Ho Hospital, Taipei Medical University; Taiwan Ministry of Science and Technology and Ministry of Health and Welfare.


  • Insurance claims data. 
  • Absence of information on sociodemographics, lifestyle, pulmonary function tests, BMI, and biomedical measures.