Mui Nicholas W, Uddin Anaz, Fortunato Michael P, Nolan Bridget E, Clare Kevin M, Lui Aiden K, Al-Juboori Mohammed, Gandhi Chirag D, Al-Mufti Fawaz
School of Medicine at New York Medical College, New York, NY, USA.
Department of Neurosurgery at Westchester Medical Center, Brain and Spine Institute at Westchester Medical Center, New York, NY, USA.
Interv Neuroradiol. 2025 Jun;31(3):369-374. doi: 10.1177/15910199231170679. Epub 2023 May 8.
ObjectivesChronic inflammation of the gastrointestinal tract is a hallmark of inflammatory bowel disease (IBD). This increased inflammation is thought to induce a hypercoagulable state that increases the risk for stroke. However, few studies have examined the association between IBD and acute ischemic stroke (AIS). Thus, this study aims to investigate the incidence, treatments, complications, and outcomes of AIS in patients with IBD.Materials & MethodsICD-9-CM and ICD-10-CM codes were used to query the National Inpatient Sample for AIS and IBD diagnosis. Baseline demographics, clinical characteristics, complications, treatments, and outcomes were assessed through descriptive statistics, multivariate regression, and propensity score matching (PSM) analysis. Acute stroke severity was assessed using the National Institute of Heath's Stroke Severity Score (SSS) as a template.Results1,609,817 patients were diagnosed with AIS between 2010 through 2019. 7468 (0.46%) had concomitant diagnoses of IBD. AIS patients with IBS were younger, more likely to be white and female, but less likely to be obese. Although IBD patients had comparable stroke severities (p = 0.64) to their non-IBS counterparts, they received stroke intervention at statistically different rates than their non-IBD counterparts. Additionally, IBD patients had higher rates of in-hospital complications (p < 0.01) and longer lengths of stay (LOS) (p < 0.01).ConclusionsIBD patients develop AIS at a younger age with similar rates of stroke severity to their non-IBD counterparts, but receive higher rates of tissue plasminogen activator administration and decreased rates of mechanical thrombectomy. Our research shows that patients with IBD are at risk for AIS at an earlier age and are more likely to have complications. This underlies a connection between IBD and a hypercoagulable state that could predispose patients to AIS.
目标
胃肠道慢性炎症是炎症性肠病（IBD）的一个标志。这种炎症增加被认为会诱发高凝状态，从而增加中风风险。然而，很少有研究探讨IBD与急性缺血性中风（AIS）之间的关联。因此，本研究旨在调查IBD患者中AIS的发病率、治疗方法、并发症及预后情况。
材料与方法
使用国际疾病分类第九版临床修订本（ICD - 9 - CM）和国际疾病分类第十版临床修订本（ICD - 10 - CM）编码，在国家住院患者样本中查询AIS和IBD诊断情况。通过描述性统计、多变量回归和倾向得分匹配（PSM）分析评估基线人口统计学特征、临床特征、并发症、治疗方法及预后情况。以美国国立卫生研究院中风严重程度评分（SSS）为模板评估急性中风严重程度。
结果
2010年至2019年期间，1,609,817例患者被诊断为AIS。7468例（0.46%）同时诊断为IBD疾病。患有IBD的AIS患者更年轻，更可能是白人及女性，但肥胖的可能性较小。尽管IBD患者与非IBD患者的中风严重程度相当（p = 0.64），但他们接受中风干预的比例与非IBD患者相比有统计学差异。此外，IBD患者的院内并发症发生率更高（p < 0.01），住院时间更长（p < 0.01）。
结论
IBD患者发生AIS的年龄更小，中风严重程度与非IBD患者相似，但接受组织纤溶酶原激活剂治疗的比例更高，机械取栓率更低。我们的研究表明，IBD患者在较早年龄就有发生AIS的风险，且更易出现并发症。这揭示了IBD与高凝状态之间的联系，这种联系可能使患者易患AIS。
