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GI Bleeding After Stroke Raises Death Risk

Triples mortality rate while still in hospital, study finds

By Alan Mozes
HealthDay Reporter


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WEDNESDAY, Aug. 6 (HealthDay News) -- Stroke patients who develop gastrointestinal bleeding while in recovery are three times as likely to die in the hospital or be heavily disabled upon release than those who do not, a new Canadian study suggests.

The finding is based on an analysis of patients who were observed while in recovery from an ischemic stroke. Ischemic strokes are the most common type of stroke -- resulting from a slowdown or blockage of blood to the brain.

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"We found that the actual incidence of gastrointestinal [GI] bleeding would make it an uncommon complication," said study author Dr. Martin O'Donnell, an associate professor in the department of medicine at McMaster University in Hamilton, Ontario. "But when it does arise, it appears to be associated with increased death and disability."

O'Donnell and his colleagues are publishing their findings in the Aug. 6 online issue of Neurology.

The authors focused on just over 6,800 men and women admitted to 11 Ontario hospitals between 2003 and 2006 following an acute ischemic stroke.

Of these patients, 829 died during their hospital stay, and 1,374 passed away within six months of their stroke.

Just 1.5 percent -- or 100 patients -- had bleeding in their stomach or intestine during their hospitalization. These patients were evenly split among men and women, and more than half had experienced a mild or moderate stroke, the research team noted.

Aside from a tripling of mortality in the hospital, stroke patients with GI bleeding were also 1.5 times more likely to die within a half-year of their stroke than those with no such complication. This observation held up even after accounting for other factors that could contribute to mortality, such as pneumonia and heart attacks.

O'Donnell noted that the relatively small number of patients he and his team tracked makes it difficult to definitively identify what type of stroke patients are at highest risk for GI bleeding -- although that is something he and his colleagues hope to explore down the road. But meanwhile, he argued that the findings already highlight some critical issues concerning stroke recovery.

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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 8/6/2008

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SOURCES: Martin O'Donnell, M.D., associate professor, department of medicine, McMaster University, Hamilton, Ontario, Canada; Matthew Fink, M.D., chief, division of stroke and critical care neurology, Weill Cornell Medical College, New York City; Larry B. Goldstein, M.D., director, The Stroke Center at Duke University Medical Center, Durham, N.C.; Aug. 6, 2008, Neurology, online


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