Association Between Gastrointestinal Bleeding With Clinical Outcome On Acute Ischemic Stroke Patient

Abstract

Background Gastrointestinal bleedingis one of the complication of acute ischemic stroke and cause of increased mortality and length of stay. This is caused by a delay in the administration of antiplatelet or anticoagulant.Objective.To find the association between gastrointestinal bleeding with clinical outcome in acute ischemic stroke patient.Methods.This study was a prospective observational, conducted at Hasan Sadikin Hospital Bandung for 4 months (November 2017-February 2018). Acute ischemic stroke patients that fulfill the inclusion and exclusion were observed while being inpatients to observe their mortality and length of stay.This study used univariat, bivariat, multivariat, and stratification analysis.Results. A total of 100 acute ischemic stroke patients were found, and 24 patients had gastrointestinal bleeding. A history of previous peptic ulcer/gastrointestinal bleeding was found most often in patient with gastrointestinal bleeding (20.8%/p=0.003).Median NIHSS score is higher (16 vs 7/p<0.001) and GCS score was lower (12 vs 15/p<0.001) in patients with gastrointestinal bleeding. Multivariate analysis showed that gastrointestinal bleeding were significantly associated with survival (p = 0.021) and length of stay (p = 0.008). The analysis of stratification showed subjects with infections who later experienced gastrointestinal bleeding had a lower risk of death and length of stay than subjects without infection who experienced gastrointestinal bleeding (1.7 vs 22.5 times and 1.5 vs 2 times).Conclusion.Gastrointestinal bleeding had more increased mortality and length of stay than without gastrointestinal bleeding in acute ischemic stroke patient.