Does a History of Stroke Affect Outcomes in Non-Variceal Upper gastrointestinal Bleed?
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Background and Purpose
Nonvariceal upper gastrointestinal bleeding (gastrointestinal) is potentially life-threatening. The study aimed to evaluate the clinical outcome in patients with upper gastrointestinal bleeding with a prior history of ischemic stroke.
Methods
The 2021 National Inpatient Sample database was employed to identify 259025 patients diagnosed with non-variceal upper gastrointestinal bleeding. 1485 patients exhibited a prior diagnosis of ischemic stroke. Data analysis was conducted using Stata version 18 to determine the primary outcome of mortality and secondary outcomes of length of hospitalization, cost, and post-hospitalization care needs.
Results
259025 patients exhibited admissions due to non-variceal upper gastrointestinal bleed, and 1485 (0.57%) patients exhibited prior diagnoses of ischemic stroke. Patients with a history of ischemic stroke had a mean age was 72.35 years with higher comorbidities. Patients with a prior history of ischemic stroke had a higher risk of in-hospital mortality (OR 7.51,p<0.01). Length of hospitalization was longer by an mean of 5.68 days (p<0.01), and a higher need for discharge to a skilled nursing facility (OR 3.30, p<0.01). Race, median annual income, and geographical distribution were statistically noncontributory to the outcomes.
Conclusion
Patients with a history of ischemic stroke who present with non-variceal upper gastrointestinal bleeding tend to be older and have a higher comorbidity index. Prior history of stroke is an independent factor that contributes to the increased mortality in patients presenting with non-variceal upper gastrointestinal bleeding. They experience increased mortality rates, prolonged hospitalizations, higher costs during hospitalization, and a greater likelihood of being discharged to a nursing facility.
