Survival outcome and mortality rate in patients with migraine: A population-based cohort study

Abstract

Background: Whether the patients with migraine have an elevated mortality risk in Taiwan is unclear. Methods: We analyzed a subset of the National Health Insurance Research Database of Taiwan and enrolled patients (≥20 years old) who received a diagnosis of migraine between 2000 and 2012. The migraine cohort was further divided into the ones ever with status migrainosus (SM) and non-status migraine (NM) subcohort and compared with a 1:4 age-, sex-, comorbidity-, and index date-matched comparison cohort. We calculated the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for subsequent mortality risk after adjustment for age, sex, and comorbidities. Results: Compared with the comparison cohort, the corresponding aHRs for mortality were 0.81 (95% CI = 0.76-0.87), 0.89 (95% CI = 0.80-0.98), and 0.78 (95% CI = 0.72-0.84) in the total migraine, SM, and NM cohorts, respectively. SM, male sex, comorbid alcohol-related illness, depression, and mental disorders were identified as risk factors for subsequent mortality. Comorbid alcohol-related illness significantly increased the mortality risk in patients with migraine. Conclusion: Taiwanese patients with migraine require comprehensive and universal medical care. These patients would benefit from controlling their migraines and reducing the subsequent mortality.