# Does a History of Stroke Affect Outcomes in Non-variceal Upper Gastrointestinal Bleeding?

## TL;DR

A history of stroke increases the risk of death and longer hospital stays for patients with upper GI bleeding.

## Contribution

This study identifies stroke history as an independent risk factor for worse outcomes in non-variceal upper GI bleeding.

## Key findings

- Stroke history is linked to a 7.51-fold higher in-hospital mortality risk in these patients.
- Patients with a prior stroke had hospital stays 5.68 days longer on average.
- Such patients were more likely to be discharged to skilled nursing facilities.

## Abstract

Background and purpose

Non-variceal upper gastrointestinal (GI) bleeding is a potentially life-threatening condition. This study aimed to evaluate clinical outcomes in patients presenting with non-variceal upper GI bleeding who had a prior history of ischemic stroke.

Methods

The 2021 National Inpatient Sample database was used to identify 259,025 patients diagnosed with non-variceal upper GI bleeding, of whom 1,485 had a documented history of ischemic stroke. Data were analyzed using Stata version 18 (StataCorp LLC, College Station, TX, US) to assess the primary outcome of in-hospital mortality. Secondary outcomes included length of hospital stay, hospitalization cost, and discharge disposition.

Results

Among the 259,025 admissions for non-variceal upper GI bleeding, 1,485 (0.57%) patients had a prior ischemic stroke. The mean age of these patients was 72.35 years, and they had a higher prevalence of comorbidities. A history of ischemic stroke was associated with significantly increased in-hospital mortality (OR 7.51, p < 0.01), a longer hospital stay by an average of 5.68 days (p < 0.01), and a greater need for discharge to a skilled nursing facility (OR 3.30, p < 0.01). No statistically significant associations were found between race, median income, or geographic region and clinical outcomes.

Conclusion

Patients with a history of ischemic stroke presenting with non-variceal upper GI bleeding are typically older and have more comorbidities. Prior stroke is an independent risk factor for increased mortality, longer hospitalization, higher healthcare costs, and a greater likelihood of discharge to a nursing facility in this population.