Risk score to predict gastrointestinal bleeding after acute ischemic stroke

Area of Science:

• Neurology
• Gastroenterology
• Clinical Risk Prediction

Background:

• Gastrointestinal bleeding (GIB) is a significant complication following stroke.
• Current methods lack a validated tool for predicting post-stroke GIB in clinical practice.

Purpose of the Study:

• To develop and validate the acute ischemic stroke associated gastrointestinal bleeding (AIS-GIB) score.
• To provide a reliable risk assessment tool for in-hospital GIB after acute ischemic stroke.

Main Methods:

• Developed the AIS-GIB score using data from the China National Stroke Registry (CNSR) with derivation and internal validation cohorts.
• Externally validated the score using data from the Chinese Intracranial Atherosclerosis Study (CICAS).
• Utilized multivariable logistic regression to identify independent predictors and receiver operating characteristic curves for model assessment.

Main Results:

• The AIS-GIB score was developed based on predictors including age, stroke severity, and medical history.
• The score demonstrated good discrimination in derivation (AUROC 0.79) and validation cohorts (internal 0.78, external 0.76).
• The AIS-GIB score was well-calibrated across all cohorts, indicating reliable predictions.

Conclusions:

• The AIS-GIB score is a validated clinical tool for predicting in-hospital GIB post-acute ischemic stroke.
• Further research is recommended to evaluate the impact of the AIS-GIB score on reducing GIB and improving patient outcomes.