Chronic Low Back Pain and Incident Transient Ischemic Attack and Stroke in General Practices in Germany

The aim was to investigate the association between chronic low back pain (CLBP) and 18 incident transient ischemic attack (TIA) and stroke in Germany. The present retrospective cohort 19 study included adults aged ≥18 years who were diagnosed for the first time with CLBP in one of 20 1,198 general practices in Germany in 2005-2019 (index date). Patients without CLBP were matched 21 to those with CLBP (1:1) using a propensity score based on age, sex, the index year, the number of 22 medical consultations per year during the follow-up, and the number of years of follow-up. In pa-23 tients without CLBP, the index date was a randomly selected visit date. Both groups were followed 24 for up to 10 years. There were 159,440 patients included in the study [mean (SD) age 52.1 (16.5) 25 years; 51.5% women]. Within 10 years of the index date, 6.5% and 5.9% of patients with and without 26 CLBP were diagnosed with TIA or stroke, respectively (log-rank p-value<0.001). The Cox regression 27 analysis corroborated these results, as there was a significant association between CLBP and inci-28 dent TIA or stroke (HR=1.28, 95% CI=1.22-1.35). CLBP was positively and significantly associated 29 with incident TIA and stroke in Germany. More research is warranted to better understand this 30 relationship.<p></p>