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Bowel Obstruction Complication of Ischemic Stroke
J Stroke Cerebrovasc Dis; ePub 2017 May 17; Rumalla, et al
Gastrointestinal bowel obstruction (GIBO) is a rare but burdensome complication of acute ischemic stroke (AIS), associated with complications, disability, and mortality, according to a recent study. The predominant form of stroke-related GIBO is nonmechanical obstruction, although the causative relationship remains unknown. Researchers queried the Nationwide Inpatient Sample (2002-2011) to identify all patients with a primary diagnosis of AIS and subsets with and without a secondary diagnosis of GIBO without hernia. They found:
- 16,987 patients with GIBO (.43%) were identified among 3,988,667 AIS hospitalizations and 4.2% of these patients underwent surgery.
- In multivariable analysis, patients aged >75 years were 2 times as likely to suffer GIBO compared to younger patients.
- African Americans were 42% more likely to have GIBO compared to whites.
- Stroke patients with pre-existing comorbidities (coagulopathy, cancer, blood loss anemia, and fluid/electrolyte disorder) were more likely to experience GIBO.
- AIS patients with GIBO were 184% and 39% times more likely to face moderate-to-severe disability and in-hospital death, respectively.
Rumalla K, Kumar AS, Mittal MK. Gastrointestinal bowel obstruction in acute ischemic stroke: Incidence, risk factors, and outcomes in a U.S. nationwide analysis of 3,998,667 hospitalizations. [Published online ahead of print May 17, 2017]. J Stroke Cerebrovasc Dis. doi:10.1016/j.jstrokecerebrovasdis.2017.04.028.