Inflammatory Bowel Disease Is Associated With Increased Risk of Acute Ischemic Stroke

Author Type(s)

Faculty, Student

Document Type

Abstract

Publication Date

12-2023

DOI

10.1016/j.jns.2023.122313

Journal Title

Journal of the Neurological Sciences

Department

Neurology

Second Department

Medicine

Third Department

Neurosurgery

Abstract

Background and aims

Chronic inflammation of the gastrointestinal tract is a hallmark of inflammatory bowel disease (IBD). This increased inflammation is thought to induce a hypercoagulable state that increases the risk for stroke. However, few studies have examined the association between IBD and acute ischemic stroke (AIS). Thus, this study aims to investigate the incidence, treatments, complications, and outcomes of AIS in patients with IBD.

Methods

ICD-9-CM and ICD-10-CM codes were used to query the National Inpatient Sample for AIS and IBD diagnosis. Baseline demographics, clinical characteristics, complications, treatments, and outcomes were assessed through descriptive statistics, multivariate regression, and propensity score matching (PSM) analysis. Acute stroke severity was assessed using the National Institute of Heath’s Stroke Severity Score (SSS) as a template.

Results

1,609,817 patients were diagnosed with AIS between 2010 and 2019. 7468 (0.46 %) had concomitant diagnoses of IBD. AIS patients with IBS were younger, more likely to be white and female, but less likely to be obese. Although IBD patients had comparable stroke severities (p = 0.64) to their non-IBS counterparts, they received stroke intervention at statistically different rates than their non-IBD counterparts. Additionally, IBD patients had higher rates of in-hospital complications (p < 0.01) and longer lengths of stay (LOS) (p < 0.01).

Conclusions

IBD patients develop AIS at a younger age with similar rates of stroke severity to their non-IBD counterparts, but receive higher rates of tissue plasminogen activator administration and decreased rates of mechanical thrombectomy. This underscores a connection between IBD and a hypercoagulable state that could predispose patients to AIS.

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