ASA: certain factors up odds of post-stroke bowel obstruction

(HealthDay)—Gastrointestinal bowel obstruction (GIBO) is associated with worse prognosis for patients with acute ischemic stroke (AIS), according to a study presented at the annual American Stroke Association's International Stroke Conference, held from Feb. 17 to 19 in Los Angeles.

Kavelin Rumalla, from the University of Missouri in Kansas City, and colleagues examined the incidence, risk factors, and outcomes of GIBO in AIS. Patients admitted with a primary diagnosis of AIS and subsets with and without a secondary diagnosis of GIBO, without hernia, were identified from the Nationwide Inpatient Sample from 2002 to 2011.

The researchers identified 16,987 patients with GIBO among 3,988,667 AIS hospitalizations. In multivariable analysis, predictors of GIBO included age (55 years and older), black race, coagulopathy, cancer, blood loss anemia, fluid/electrolyte disorder, weight loss, and thrombolytic therapy (all P < 0.0001). Patients with GIBO were more likely to suffer intubation, deep vein thrombosis, pulmonary embolism, sepsis, acute kidney injury, gastrointestinal hemorrhage, and blood transfusions (all P < 0.0001). AIS patients with GIBO were more likely to face moderate to severe disability and in-hospital death (P < 0.001), in adjusted analyses. Length of stay and total costs were also increased with GIBO occurrence (both P < 0.0001).

"Advanced age, black race, and several pre-existing comorbidities increase the likelihood of post-AIS GIBO, which is an independent predictor of in-hospital complications, disability, and mortality," the authors write.