Analysis of risk factors for gastrointestinal bleeding in patients with cerebral infarction during hospitalization
10.3969/j.issn.1672-5921.2025.03.004
- VernacularTitle:脑梗死患者住院期间发生消化道出血的危险因素分析
- Author:
Lingli MA
1
Author Information
1. 266400 青岛西海岸新区人民医院神经内科
- Publication Type:Journal Article
- Keywords:
Cerebral infarction;
Gastrointestinal bleeding;
Risk factors
- From:
Chinese Journal of Cerebrovascular Diseases
2025;22(3):178-187
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors for gastrointestinal bleeding in patients with cerebral infarction during hospitalization.Methods This retrospective study included patients with cerebral infarction admitted to the Department of Neurology at West Coast New District People's Hospital of Qingdao from January 2022 to December 2024.Baseline characteristics,including age,gender,admission systolic and diastolic blood pressure,and National Institutes of Health stroke scale(NIHSS)score at admission,medical history(hypertension,diabetes mellitus,coronary artery disease,atrial fibrillation,history of cerebral infarction,dyslipidemia,and gastrointestinal disease[gastritis or gastric ulcer]),infarction location(anterior circulation,posterior circulation,or multiple infarcts),trial of Org 10172 in acute stroke treatment(TOAST)classification,laboratory parameters at admission(hemoglobin,platelet count,prothrombin time[PT],and activated partial thromboplastin time)and the treatment status(antiplatelet therapy,anticoagulation,intravenous thrombolysis,lipid-lowering therapy,and prophylactic proton pump inhibitor use)were collected for all patients.Patients were divided into bleeding group and non-bleeding group based on the occurrence of gastrointestinal bleeding during hospitalization as diagnosed according to the Expert Consensus on Emergency Diagnosis and Treatment Procedures for Acute Upper Gastrointestinal Bleeding(2020 Edition).The length of hospital stay and in-hospital all-cause mortality were compared between the two groups.Variables with statistically significant differences in univariate analysis were further examined using multivariate Logistic regression to evaluate the risk factors for gastrointestinal bleeding in patients with cerebral infarction.Results A total of 344 patients with cerebral infarction were enrolled in this study,including 201 males and 143 females,aged 32-91 years,with an average age of(68±12)years.Among them,22 cases(6.4％)were experienced gastrointestinal bleeding,while 322 cases(93.6％)did not.(1)Patients in the bleeding group has higher age([74±12]years vs.[67±12]years),NIHSS score at admission(8[4,20]vs.2[2,4]),PT at admission([13.1±1.5]s vs.[12.4±1.1]s),history of coronary heart disease(50.0％[11/22]vs.20.8％[67/322]),history of atrial fibrillation(50.0％[11/22]vs.15.5％[50/322]),history of gastrointestinal disease(27.3％[6/22]vs.14.3％[46/322]),intravenous thrombolysis(22.7％[5/22]vs.2.2％[7/322])than those in the non-bleeding group(all P＜0.05).The hemoglobin count at admission([118±21]g/L vs.[135±16]g/L),and the use of antiplatelet therapy(59.1％[13/22]vs.79.5％[256/322])were lower in the bleeding group(all P＜0.05).The in-hospital all-cause mortality rate(40.9％[9/22]vs.1.6％[5/322])and the length of hospital stay([11.24±2.90]d vs.[6.96±1.42]d)were significantly higher in the bleeding group(all P＜0.05).Significant differences were also observed in the infarct sites distribution and TOAST types between the two groups(both P＜0.01).No other variables in the univariate analysis demonstrated a statistically significant difference(all P＞0.05).(2)Multivariate Logistic regression analysis showed that a high NIHSS score at admission(OR,1.183,95％CI 1.112-1.259,P＜0.01),cardiogenic embolic subtype(OR,2.858,95％CI 1.302-7.917,P=0.043),antiplatelet therapy(OR,2.142,95％CI 1.238-3.705,P=0.006),and intravenous thrombolysis(OR,7.242,95％ CI 1.802-29.110,P=0.005)were the risk factors of gastrointestinal bleeding in patients with cerebral infarction.Conclusion High NIHSS score at admission,cardiogenic embolic subtype,antiplatelet therapy and intravenous thrombolysis are significant risk factors for gastrointestinal bleeding in patients with cerebral infarction during hospitalization.
