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Published on: February 8, 2022
Risk factors for gastrointestinal bleeding in patients with intracerebral hemorrhage: A propensity score matching
Qiuping Gu1, Chunping Zhu1, Jiaming Huang2
1Department of Gastroenterology, Nanchang University Affiliated Ganzhou Hospital, Ganzhou People's Hospital, Ganzhou, Jiangxi 341000, China.
Insights
High Rate Pressure Product (RPP) and low Glasgow Coma Score (GCS) are independent risk factors for gastrointestinal bleeding (GIB) in patients with intracerebral hemorrhage (ICH). Proton pump inhibitors (PPIs) showed a protective effect against GIB.
Area of Science:
- Cardiology
- Neurology
- Gastroenterology
Background:
- Gastrointestinal bleeding (GIB) is a frequent complication following intracerebral hemorrhage (ICH).
- Rate Pressure Product (RPP), a hemodynamic index, correlates with cardiovascular and cerebrovascular disease prognosis.
Purpose of the Study:
- To investigate the association between Rate Pressure Product (RPP) and the occurrence of gastrointestinal bleeding (GIB) in patients diagnosed with intracerebral hemorrhage (ICH).
Main Methods:
- Retrospective analysis of 1232 ICH patients (January 2019 - December 2021).
- Patients categorized into GIB and non-GIB groups; propensity score matching applied.
- Univariate and multivariate conditional logistic regression analyses performed to identify risk and protective factors for GIB.
Main Results:
- High RPP, low Glasgow Coma Score (GCS), and urokinase identified as independent risk factors for GIB.
- Proton pump inhibitors (PPIs) emerged as a protective factor against GIB.
- Univariate analysis also implicated fibrinogen and D-dimer in GIB occurrence.
Conclusions:
- High RPP, low GCS, and urokinase are significant independent risk factors for GIB in ICH patients.
- PPIs demonstrate a protective role in mitigating GIB risk.
- Close monitoring for GIB is recommended in high-risk ICH patients; further multicenter prospective studies are warranted.
Background:
Gastrointestinal bleeding (GIB) is a common complication of intracerebral hemorrhage (ICH). Rate pressure product (RPP) is an objective hemodynamic index that is closely related to the prognosis of cardia-cerebrovascular disease. The purpose of this study was to investigate the relationship between RPP and GIB in ICH patients.
Methods:
We retrospectively analyzed data from ICH patients admitted to the neurosurgery department of Nanchang University affiliated with Ganzhou Hospital from January 2019 to December 2021. The patients were divided into a GIB group and a non-GIB group according to whether they had GIB. Propensity score matching was used to match between the two groups. Univariate analysis was used to select factors affecting GIB, and multivariate conditional logistic regression was used to analyze the independent factors associated with GIB.
Results:
There were 1232 patients included in the study, including 182 in the GIB group and 1050 in the non-GIB group, and 182 pairs of patients were successfully matched through propensity score matching. The univariate analysis showed that high RPP, low Glasgow coma score (GCS), fibrinogen, D-dimer and PPIs were factors associated with GIB. Multivariate conditional logistic regression showed that high RPP, low GCS and urokinase were independent risk factors for GIB, and PPIs was a protective factor for GIB.
Conclusions:
High RPP, low GCS and urokinase were independent risk factors for GIB, and PPIs was a protective factor for GIB. Patients with a high risk of developing GIB should be monitored closely. Nevertheless, multicenter prospective studies with more patients are needed to further validate the results.
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