Impact of inflammatory bowel disease on hospital outcomes in acute ischemic stroke: a nationwide cohort study

Int J Colorectal Dis. 2021 Aug;36(8):1759-1764. doi: 10.1007/s00384-021-03912-y. Epub 2021 Mar 17.


Purpose: Patients with inflammatory bowel disease (IBD) have an increased risk of venous thrombotic events. The impact IBD has on arterial thrombosis is not well characterized. We aimed to identify the impact of IBD on hospital outcomes in patients admitted for acute ischemic stroke (AIS).

Methods: This is a retrospective cohort study utilizing the 2017 National Inpatient Sample. We identified all adult patients with a principal diagnosis of AIS and compared those with a concurrent diagnosis of IBD to those without-subgrouped by ulcerative colitis (UC) and Crohn's disease (CD). Outcomes were mortality and healthcare usage among IBD patients with AIS. Multivariate analysis was used to control for confounders. Analyses were performed using STATA.

Results: Five hundred twenty-four thousand and forty-five patients were admitted for AIS in 2017; of them 2200 (0.41%) had a concurrent diagnosis of IBD. The presence of IBD did not significantly affect in-hospital mortality (4.09% vs. 4.01%) among patients admitted for AIS [OR 1.07 95% CI: 0.65-1.76], with similar findings upon subgroup analysis of UC [OR 0.91, 95% CI: 0.39-2.09] and CD [OR 1.17, 95% CI: 0.62-2.19]. Mean hospital length of stay and charges/costs in AIS were similar irrespective of IBD.

Conclusions: UC and CD do not appear to be associated with a higher risk of mortality or increased healthcare usage in AIS. AIS risk assessment in patients with IBD is important but should be done in a similar fashion to the general population.

Keywords: Acute ischemic stroke; Inflammatory bowel disease; Mortality; Outcomes.

MeSH terms

  • Adult
  • Brain Ischemia*
  • Cohort Studies
  • Colitis, Ulcerative* / complications
  • Colitis, Ulcerative* / epidemiology
  • Hospitals
  • Humans
  • Inflammatory Bowel Diseases* / complications
  • Inflammatory Bowel Diseases* / epidemiology
  • Ischemic Stroke*
  • Retrospective Studies
  • Stroke* / complications
  • Stroke* / epidemiology