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Endoscopy Is Relatively Safe in Patients with Acute Ischemic Stroke and Gastrointestinal Hemorrhage

  • Mohamed Tausif Siddiqui
  • Mohammad Bilal
  • Lakshmi Asritha Gollapudi
  • Dhruv Mehta
  • Shifa Umar
  • Jonathan Barsa
  • Christopher Nabors
  • Beth Schorr-Lesnick
  • Edward Lebovics
  • Virendra Tewari
Original Article
  • 15 Downloads

Abstract

Background

Gastrointestinal hemorrhage (GIH) is reported to occur in 1–8% of patients admitted with acute ischemic stroke (AIS). AIS is considered to be a relative contraindication to GIE.

Aims

Evaluate the outcomes of gastrointestinal endoscopy (GIE) in patients hospitalized with AIS and GIH.

Methods

Patients hospitalized with AIS and GIH were included from the National Inpatient Sample 2005–2014. Primary outcome measure was in-hospital mortality in patients with AIS and GIH who underwent gastrointestinal endoscopy. Secondary outcomes were (1) resource utilization as measured by length of stay (LOS) and total hospitalization costs and (2) to identify independent predictors of undergoing GIE in patients with AIS and GIH. Confounders were adjusted for by using multivariable regression analysis.

Results

A total of 75,756 hospitalizations were included in the analysis. Using a multivariate analysis, the in-hospital mortality was significantly lower in patients who underwent GIE as compared to those who did not [aOR: 0.4, P < 0.001]. Patients who underwent GIE also had significantly shorter adjusted mean LOS [adjusted mean difference in LOS: 0.587 days, P < 0.001]. Patients with AIS and GIH who did not undergo GIE had significantly higher adjusted total hospitalization costs. [Mean adjusted difference in total hospitalization costs was $5801 (P < 0.001).] Independent predictors of undergoing GIE in this population were male gender, age > 65 years, Asian or Pacific race, hypovolemic shock, need for blood transfusion and admission to urban non-teaching hospital.

Conclusions

Gastrointestinal endoscopy can be safely performed in a substantial number of patients with AIS and GIH.

Keywords

Gastrointestinal hemorrhage Acute ischemic stroke Endoscopy Colonoscopy Gastrointestinal bleeding 

Notes

Compliance with ethical standards

Conflict of interest

Authors do not have any financial or non-financial disclosure, and there is no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Mohamed Tausif Siddiqui
    • 1
  • Mohammad Bilal
    • 2
  • Lakshmi Asritha Gollapudi
    • 3
  • Dhruv Mehta
    • 3
  • Shifa Umar
    • 4
  • Jonathan Barsa
    • 3
  • Christopher Nabors
    • 1
  • Beth Schorr-Lesnick
    • 3
  • Edward Lebovics
    • 3
  • Virendra Tewari
    • 3
  1. 1.Department of Internal MedicineNew York Medical CollegeValhallaUSA
  2. 2.Division of Gastroenterology and HepatologyUniversity of Texas Medical BranchGalvestonUSA
  3. 3.Department of GastroenterologyNew York Medical CollegeValhallaUSA
  4. 4.Division of Gastroenterology, Hepatology and NutritionAllegheny Health NetworkPittsburghUSA

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