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. 2024 Jul 5;24(1):216.
doi: 10.1186/s12876-024-03312-w.

Association and temporal sequence of pneumonia and gastrointestinal bleeding after acute ischemic stroke

Runhua Zhang  1   2 , Huiqing Hou  1 , Xingquan Zhao  1   3 , Liping Liu  1   3 , Yilong Wang  1   3 , Gaigen Liu  1   3 , Yongjun Wang  1   3 , Ruijun Ji  4   5
Affiliations

Association and temporal sequence of pneumonia and gastrointestinal bleeding after acute ischemic stroke

Runhua Zhang et al. BMC Gastroenterol. .

Abstract

Background: Stroke-associated pneumonia (SAP) and gastrointestinal bleeding (GIB) are common medical complications after stroke. The previous study suggested a strong association between SAP and GIB after stroke. However, little is known about the time sequence of SAP and GIB. In the present study, we aimed to verify the association and clarify the temporal sequence of SAP and GIB after ischemic stroke.

Methods: Patients with ischemic stroke from in-hospital Medical Complication after Acute Stroke study were analyzed. Data on occurrences of SAP and GIB during hospitalization and the intervals from stroke onset to diagnosis of SAP and GIB were collected. Multiple logistic regression was used to evaluate the association between SAP and GIB. Kruskal-Wallis test was used to compare the time intervals from stroke onset to diagnosis of SAP and GIB.

Results: A total of 1129 patients with ischemic stroke were included. The median length of hospitalization was 14 days. Overall, 86 patients (7.6%; 95% CI, 6.1-9.2%) developed SAP and 47 patients (4.3%; 95% CI, 3.0-5.3%) developed GIB during hospitalization. After adjusting potential confounders, SAP was significantly associated with the development of GIB after ischemic stroke (OR = 5.13; 95% CI, 2.02-13.00; P < 0.001). The median time from stroke onset to diagnosis of SAP was shorter than that of GIB after ischemic stroke (4 days vs. 5 days; P = 0.039).

Conclusions: SAP was associated with GIB after ischemic stroke, and the onset time of SAP was earlier than that of GIB. It is imperative to take precautions to prevent GIB in stroke patients with SAP.

Keywords: Gastrointestinal bleeding; Pneumonia; Stroke; Temporal sequence.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The proportion distribution of days from ischemic stroke onset to complications diagnosis in patients with pneumonia and gastrointestinal bleeding. SAP, stroke-associated pneumonia; GIB, gastrointestinal bleeding
Fig. 2
Fig. 2
The distribution of days from ischemic stroke onset to pneumonia and gastrointestinal bleeding diagnosis. SAP, stroke-associated pneumonia; GIB, gastrointestinal bleeding
See this image and copyright information in PMC

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