1.Long-Term Incidence of Gastrointestinal Bleeding Following Ischemic Stroke
Jun Yup KIM ; Beom Joon KIM ; Jihoon KANG ; Do Yeon KIM ; Moon-Ku HAN ; Seong-Eun KIM ; Heeyoung LEE ; Jong-Moo PARK ; Kyusik KANG ; Soo Joo LEE ; Jae Guk KIM ; Jae-Kwan CHA ; Dae-Hyun KIM ; Tai Hwan PARK ; Kyungbok LEE ; Hong-Kyun PARK ; Yong-Jin CHO ; Keun-Sik HONG ; Kang-Ho CHOI ; Joon-Tae KIM ; Dong-Eog KIM ; Jay Chol CHOI ; Mi-Sun OH ; Kyung-Ho YU ; Byung-Chul LEE ; Kwang-Yeol PARK ; Ji Sung LEE ; Sujung JANG ; Jae Eun CHAE ; Juneyoung LEE ; Min-Surk KYE ; Philip B. GORELICK ; Hee-Joon BAE ;
Journal of Stroke 2025;27(1):102-112
Background:
and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes.
Methods:
We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data.
Results:
Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4.
Conclusion
Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.
2.Long-Term Incidence of Gastrointestinal Bleeding Following Ischemic Stroke
Jun Yup KIM ; Beom Joon KIM ; Jihoon KANG ; Do Yeon KIM ; Moon-Ku HAN ; Seong-Eun KIM ; Heeyoung LEE ; Jong-Moo PARK ; Kyusik KANG ; Soo Joo LEE ; Jae Guk KIM ; Jae-Kwan CHA ; Dae-Hyun KIM ; Tai Hwan PARK ; Kyungbok LEE ; Hong-Kyun PARK ; Yong-Jin CHO ; Keun-Sik HONG ; Kang-Ho CHOI ; Joon-Tae KIM ; Dong-Eog KIM ; Jay Chol CHOI ; Mi-Sun OH ; Kyung-Ho YU ; Byung-Chul LEE ; Kwang-Yeol PARK ; Ji Sung LEE ; Sujung JANG ; Jae Eun CHAE ; Juneyoung LEE ; Min-Surk KYE ; Philip B. GORELICK ; Hee-Joon BAE ;
Journal of Stroke 2025;27(1):102-112
Background:
and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes.
Methods:
We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data.
Results:
Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4.
Conclusion
Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.
3.Long-Term Incidence of Gastrointestinal Bleeding Following Ischemic Stroke
Jun Yup KIM ; Beom Joon KIM ; Jihoon KANG ; Do Yeon KIM ; Moon-Ku HAN ; Seong-Eun KIM ; Heeyoung LEE ; Jong-Moo PARK ; Kyusik KANG ; Soo Joo LEE ; Jae Guk KIM ; Jae-Kwan CHA ; Dae-Hyun KIM ; Tai Hwan PARK ; Kyungbok LEE ; Hong-Kyun PARK ; Yong-Jin CHO ; Keun-Sik HONG ; Kang-Ho CHOI ; Joon-Tae KIM ; Dong-Eog KIM ; Jay Chol CHOI ; Mi-Sun OH ; Kyung-Ho YU ; Byung-Chul LEE ; Kwang-Yeol PARK ; Ji Sung LEE ; Sujung JANG ; Jae Eun CHAE ; Juneyoung LEE ; Min-Surk KYE ; Philip B. GORELICK ; Hee-Joon BAE ;
Journal of Stroke 2025;27(1):102-112
Background:
and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes.
Methods:
We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data.
Results:
Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4.
Conclusion
Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.
4.Characteristics of High-Risk Groups for Suicide in Korea Before and After the COVID-19 Pandemic: K-COMPASS Cohort Study
Jeong Hun YANG ; Dae Hun KANG ; C. Hyung Keun PARK ; Min Ji KIM ; Sang Jin RHEE ; Min-Hyuk KIM ; Jinhee LEE ; Sang Yeol LEE ; Won Sub KANG ; Seong-Jin CHO ; Shin Gyeom KIM ; Se-Hoon SHIM ; Jung-Joon MOON ; Jieun YOO ; Weon-Young LEE ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):246-259
Objectives:
This study examined the changes in the characteristics of high-risk suicide groups in South Korea before and after the COVID-19 pandemic using the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) cohort.
Methods:
The K-COMPASS is a longitudinal cohort study that started in 2015. The participants included suicide attempters and individuals with suicidal ideation from various hospitals and mental health centers in South Korea. This study compared the sociodemographic and psychiatric characteristics of 800 participants from the first cohort (2015–2019) with 511 participants from the second and third cohorts (2019–2024). Data were collected through structured interviews and validated scales.
Results:
The second and third cohort participants were younger, had a higher proportion of females, and exhibited more severe psychiatric symptoms and higher suicidal risk than the first cohort. The prevalence of physical illnesses decreased, while the use of psychiatric medications and the severity of mental health issues increased. In addition, significant sociodemographic changes were observed, such as higher educational levels and urban residency.
Conclusion
Significant shifts in the characteristics of high-risk suicide groups were observed during the COVID-19 pandemic, highlighting the need for targeted mental health interventions focusing on younger individuals and females to prevent suicide in high-risk groups.
5.Characteristics of High-Risk Groups for Suicide in Korea Before and After the COVID-19 Pandemic: K-COMPASS Cohort Study
Jeong Hun YANG ; Dae Hun KANG ; C. Hyung Keun PARK ; Min Ji KIM ; Sang Jin RHEE ; Min-Hyuk KIM ; Jinhee LEE ; Sang Yeol LEE ; Won Sub KANG ; Seong-Jin CHO ; Shin Gyeom KIM ; Se-Hoon SHIM ; Jung-Joon MOON ; Jieun YOO ; Weon-Young LEE ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):246-259
Objectives:
This study examined the changes in the characteristics of high-risk suicide groups in South Korea before and after the COVID-19 pandemic using the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) cohort.
Methods:
The K-COMPASS is a longitudinal cohort study that started in 2015. The participants included suicide attempters and individuals with suicidal ideation from various hospitals and mental health centers in South Korea. This study compared the sociodemographic and psychiatric characteristics of 800 participants from the first cohort (2015–2019) with 511 participants from the second and third cohorts (2019–2024). Data were collected through structured interviews and validated scales.
Results:
The second and third cohort participants were younger, had a higher proportion of females, and exhibited more severe psychiatric symptoms and higher suicidal risk than the first cohort. The prevalence of physical illnesses decreased, while the use of psychiatric medications and the severity of mental health issues increased. In addition, significant sociodemographic changes were observed, such as higher educational levels and urban residency.
Conclusion
Significant shifts in the characteristics of high-risk suicide groups were observed during the COVID-19 pandemic, highlighting the need for targeted mental health interventions focusing on younger individuals and females to prevent suicide in high-risk groups.
6.Characteristics of High-Risk Groups for Suicide in Korea Before and After the COVID-19 Pandemic: K-COMPASS Cohort Study
Jeong Hun YANG ; Dae Hun KANG ; C. Hyung Keun PARK ; Min Ji KIM ; Sang Jin RHEE ; Min-Hyuk KIM ; Jinhee LEE ; Sang Yeol LEE ; Won Sub KANG ; Seong-Jin CHO ; Shin Gyeom KIM ; Se-Hoon SHIM ; Jung-Joon MOON ; Jieun YOO ; Weon-Young LEE ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):246-259
Objectives:
This study examined the changes in the characteristics of high-risk suicide groups in South Korea before and after the COVID-19 pandemic using the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) cohort.
Methods:
The K-COMPASS is a longitudinal cohort study that started in 2015. The participants included suicide attempters and individuals with suicidal ideation from various hospitals and mental health centers in South Korea. This study compared the sociodemographic and psychiatric characteristics of 800 participants from the first cohort (2015–2019) with 511 participants from the second and third cohorts (2019–2024). Data were collected through structured interviews and validated scales.
Results:
The second and third cohort participants were younger, had a higher proportion of females, and exhibited more severe psychiatric symptoms and higher suicidal risk than the first cohort. The prevalence of physical illnesses decreased, while the use of psychiatric medications and the severity of mental health issues increased. In addition, significant sociodemographic changes were observed, such as higher educational levels and urban residency.
Conclusion
Significant shifts in the characteristics of high-risk suicide groups were observed during the COVID-19 pandemic, highlighting the need for targeted mental health interventions focusing on younger individuals and females to prevent suicide in high-risk groups.
7.Psychotropic Medications Promote Time-Dependent Reduction of Suicidal Ideation in Mood Disorder: A Prospective Cohort Study
Jeong Hun YANG ; C. Hyung Keun PARK ; Sang Jin RHEE ; Dae Hun KANG ; Min Ji KIM ; Hyun Jeong LEE ; Sang Yeol LEE ; Se-Hoon SHIM ; Jung-Joon MOON ; Seong-Jin CHO ; Shin Gyeom KIM ; Min-Hyuk KIM ; Jinhee LEE ; Won Sub KANG ; Jieun YOO ; Weon-Young LEE ; Yong Min AHN
Journal of Korean Medical Science 2024;39(31):e226-
Background:
Despite a plethora of research on the topic, there is still no solid evidence that pharmacological treatment actually reduces the risk of suicide in patients with mental illness.In this study, we aimed to assess the effect of psychotropic medications on suicidal ideation in patients with major depressive disorder (MDD) and bipolar disorder (BPD) in two age groups: less than 25 years and 25 years and older.
Methods:
We analyzed 312 patients with mood disorders with current suicidal thoughts or recent suicide attempts. We followed the participants from baseline for 6 months and assessed changes in suicidal ideation with Columbia-Suicide Severity Rating Scale (C-SSRS).The effect of psychotropic drug administration on suicidal ideation over time was analyzed using a linear mixed model.
Results:
In patients aged 25 years and older with mood disorders, suicidal ideation was more severe when using psychotropic drugs than when not using them. However, suicidal ideation decreased rapidly over time. The time-dependent reduction in suicidal ideation was accelerated when using antidepressants and sedatives/hypnotics in adult MDD, and when using mood stabilizers in adult BPD. However, this effect was not observed in participants aged less than 25 years.
Conclusion
Adequate psychotropic medication may reduce suicidal ideation in patients with mood disorders aged 25 years and older. Additional research on psychotropic drugs is needed to effectively reduce the risk of suicide among children and adolescents with mood disorders.
8.Risk Factors and Trends in Adolescent’s Suicide Attempt Rates Before and After the Coronavirus Disease 2019 Pandemic
Su-In JUNG ; Sang-Yeol LEE ; Dae-Jin KIM ; Chan-Mo YANG
Journal of Korean Medical Science 2024;39(3):e32-
Background:
Understanding adolescents’ mental health during the coronavirus disease 2019 (COVID-19) pandemic and identifying those most at risk is an urgent public health challenge.This study explored the trend of suicide attempts and the association between loneliness, family financial stress, and suicide attempts during the COVID-19 pandemic among adolescents.
Methods:
Data of the 2020 to 2022 Korea Youth Risk Behavior Surveys for adolescents aged 13–18 years were used. Multivariate logistic regression analyses were performed to examine the association between suicide attempts, family financial stress, and loneliness during the COVID-19 pandemic.
Results:
The trend of suicide attempt rates was lowest in 2020 (1.9%, 1,034 out of 53,534) and it showed an increasing trend with rates of 2.2% (1,159 out of 53,445) in 2021 and 2.5% (1,271 out of 50,455) in 2022. The risk of suicide attempt was higher among adolescents who experienced financial stress (in 2020: adjusted odds ratio [AOR], 1.53, 95% confidence interval [CI], 1.26–1.88; in 2021: AOR, 1.63, 95% CI, 1.03–1.54) and felt lonely (in 2020: AOR, 2.19, 95% CI, 1.78–2.70; in 2021: AOR, 2.65, 95% CI, 2.16–3.26; in 2022: AOR, 1.3, 95% CI, 1.04–1.55) than those who did not.
Conclusion
The COVID-19 pandemic affected the suicide attempts of adolescents, with financial stress and feelings of loneliness closely linked to this impact. Although the pandemic nears its end, the persistent risk of suicide attempts among adolescents remains a concern. Therefore, it is imperative to implement targeted screening and interventions to address adolescent suicide risk.
9.Contemporary Statistics of Acute Ischemic Stroke and Transient Ischemic Attack in 2021: Insights From the CRCS-K-NIH Registry
Do Yeon KIM ; Tai Hwan PARK ; Yong-Jin CHO ; Jong-Moo PARK ; Kyungbok LEE ; Minwoo LEE ; Juneyoung LEE ; Sang Yoon BAE ; Da Young HONG ; Hannah JUNG ; Eunvin KO ; Hyung Seok GUK ; Beom Joon KIM ; Jun Yup KIM ; Jihoon KANG ; Moon-Ku HAN ; Sang-Soon PARK ; Keun-Sik HONG ; Hong-Kyun PARK ; Jeong-Yoon LEE ; Byung-Chul LEE ; Kyung-Ho YU ; Mi Sun OH ; Dong-Eog KIM ; Dong-Seok GWAK ; Soo Joo LEE ; Jae Guk KIM ; Jun LEE ; Doo Hyuk KWON ; Jae-Kwan CHA ; Dae-Hyun KIM ; Joon-Tae KIM ; Kang-Ho CHOI ; Hyunsoo KIM ; Jay Chol CHOI ; Joong-Goo KIM ; Chul-Hoo KANG ; Sung-il SOHN ; Jeong-Ho HONG ; Hyungjong PARK ; Sang-Hwa LEE ; Chulho KIM ; Dong-Ick SHIN ; Kyu Sun YUM ; Kyusik KANG ; Kwang-Yeol PARK ; Hae-Bong JEONG ; Chan-Young PARK ; Keon-Joo LEE ; Jee Hyun KWON ; Wook-Joo KIM ; Ji Sung LEE ; Hee-Joon BAE ;
Journal of Korean Medical Science 2024;39(34):e278-
This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively.Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques.There has been a decrease in intravenous thrombolysis rates, from 12% in 2017–2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for noncardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.
10.Characteristics of High-Risk Groups for Suicide in Korea Before and After the COVID-19 Pandemic: K-COMPASS Cohort Study
Jeong Hun YANG ; Dae Hun KANG ; C. Hyung Keun PARK ; Min Ji KIM ; Sang Jin RHEE ; Min-Hyuk KIM ; Jinhee LEE ; Sang Yeol LEE ; Won Sub KANG ; Seong-Jin CHO ; Shin Gyeom KIM ; Se-Hoon SHIM ; Jung-Joon MOON ; Jieun YOO ; Weon-Young LEE ; Yong Min AHN
Journal of Korean Neuropsychiatric Association 2024;63(4):246-259
Objectives:
This study examined the changes in the characteristics of high-risk suicide groups in South Korea before and after the COVID-19 pandemic using the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) cohort.
Methods:
The K-COMPASS is a longitudinal cohort study that started in 2015. The participants included suicide attempters and individuals with suicidal ideation from various hospitals and mental health centers in South Korea. This study compared the sociodemographic and psychiatric characteristics of 800 participants from the first cohort (2015–2019) with 511 participants from the second and third cohorts (2019–2024). Data were collected through structured interviews and validated scales.
Results:
The second and third cohort participants were younger, had a higher proportion of females, and exhibited more severe psychiatric symptoms and higher suicidal risk than the first cohort. The prevalence of physical illnesses decreased, while the use of psychiatric medications and the severity of mental health issues increased. In addition, significant sociodemographic changes were observed, such as higher educational levels and urban residency.
Conclusion
Significant shifts in the characteristics of high-risk suicide groups were observed during the COVID-19 pandemic, highlighting the need for targeted mental health interventions focusing on younger individuals and females to prevent suicide in high-risk groups.

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