Objective:

Background:

Cervical artery dissection is a cause of stroke, especially in young adults. It is plausible that autoimmune disease increases the risk of arterial dissection via adverse effects of inflammation on the vessel wall, but this hypothesis has not been clearly tested. We examined the association between autoimmune disease and cervical artery dissection.

Design/Methods:

We performed a retrospective case-control study using linked electronic health record and insurance claims on >11 million patients at 29 healthcare organizations across the U.S. Previously validated ICD-10 diagnosis codes were used to identify adults hospitalized with ischemic stroke from 2016-2024. We used previously validated ICD-10 codes to identify stroke patients with cervical artery dissection (cases) versus those without dissection (controls). A broad set of ICD-10 codes were used to ascertain the exposure of autoimmune disease. We calculated unadjusted odds ratios and then used multiple logistic regression to adjust for demographics.

Results:

We identified 60,876 patients hospitalized with ischemic stroke. Their mean age was 55.2 years, 43% female, 57% white, median NIHSS score was 4 (IQR, 1-11), and approximately two-thirds were discharged home or to acute rehabilitation facility. Of these patients, 1,868 had cervical artery dissection (cases) and 59,008 did not (controls). Patients with dissection were slightly younger (55.2 vs 59.9 years) but otherwise broadly similar to control patients without dissection. In unadjusted analysis, we found a statistically significant association between autoimmune disease and cervical artery dissection (OR, 1.16; 95% CI, 1.01-1.33). After adjustment for demographics the association was similar but not statistically significant (OR, 1.14; 95% CI, 0.994-1.31).

Conclusions: