Objectives

The extent of hereditary haemorrhagic telangiectasia (HHT) and pulmonary arteriovenous malformations (PAVMs) as a risk factor for brain abscess is unknown.

Methods

Nationwide and population-based registries were used to identify persons with first-time hospitalization for brain abscess (index date) and population controls matched by age, sex and residence (1:10). Accounting for competing risks, cumulative incidence curves of new diagnosis of HHT/PAVM after brain abscess were constructed. Next, Cox regression was used for computation of cause-specific hazard rate ratios (HRRs) adjusted for severe liver disease and congenital heart disease as potential confounders.

Results

HHT/PAVM was prevalent before the index date in 2/1384 (0.1%; 95% CI 0.02–0.52) brain abscess patients and 6/13 838 (0.04%; 95% CI 0.02–0.09) matched population controls. After the index date, a new diagnosis of hereditary haemorrhagic telangiectasia or pulmonary arteriovenous malformations was made in 15/1384 brain abscess patients (range 0 days to 17 years) compared with 7/13 812 population controls yielding an adjusted hazard rate ratio of 31.4 (95% CI 9.95–98.9). Cumulative incidence was 1.5% for brain abscess patients and 0.1% for population controls.

Discussion

HHT/PAVM should be considered in patients with cryptogenic brain abscess, although absolute risk is low.

中文翻译：

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脑脓肿患者的遗传性出血性毛细血管扩张和肺动静脉畸形：一项基于人群的全国性队列研究。

目标

遗传性出血性毛细血管扩张（HHT）和肺动静脉畸形（PAVMs）作为脑脓肿的危险因素的程度尚不清楚。

方法

在全国范围内和基于人口的登记处用于识别因脑脓肿（索引日期）和年龄，性别和居住地匹配的人口控制而首次住院的患者（1:10）。考虑到竞争风险，构建脑脓肿后新诊断HHT / PAVM的累积发生率曲线。接下来，将Cox回归用于计算因潜在的混杂因素而针对严重肝病和先天性心脏病进行了调整的特定原因的风险比（HRR）。

结果

HHT / PAVM在索引日期之前普遍存在于2/1384（0.1％; 95％CI 0.02-0.52）脑脓肿患者和6/13 838（0.04％; 95％CI 0.02-0.09）匹配的人群对照中。在索引日期之后，对15/1384名脑脓肿患者（0天至17岁）进行了遗传性出血性毛细血管扩张或肺动静脉畸形的新诊断，而7/13 812人群对照组的调整后的患病率是31.4（ 95％CI 9.95–98.9）。脑脓肿患者的累积发生率为1.5％，人口对照患者的累积发生率为0.1％。

讨论区

尽管绝对风险很低，但对于隐源性脑脓肿的患者应考虑使用HHT / PAVM。