Gastrointestinal Bleeding in Acute Ischemic Stroke: Recent Trend and Predictors. (P6.040)

OBJECTIVE: To determine trends and independent predictors of Gastrointestinal bleeding (GIB) in all Acute Ischemic Stroke admissions. BACKGROUND: Major bleeding has been reported to be common after acute ischemic stroke (AIS), most often gastrointestinal. We sought to determine trends and independent predictors of gastrointestinal bleeding (GIB) in all AIS admissions. DESIGN/METHODS: We reviewed Healthcare Cost and Utilization Project9s Nationwide Inpatient Sample(NIS) database from 2009­2012 for AIS admissions adults using the ICD 9CM codes. GIB was identified as presence of secondary ICD9CM codes. Co morbidities were defined by Deyo9s modification of Charlson9s Comorbidity Index(CCI). Hierarchical multivariable regression model and Cochrane Armitage trend test were utilized. RESULTS: 1735416 AIS hospitalizations were identified out of which 21442(1.24[percnt]) developed GIB during hospitalization. On periodic trend analysis, incidence of GIB decreased from 1.35[percnt] (2009) to 1.13[percnt](2012)(p<0.001). A multivariable regression model association of GIB and IV thrombolysis [Odds ratio(OR):1.18; 95[percnt]confidence interval(CI):0.93­1.50; p=0.07)] and mechanical thrombectomy (OR 0.91; 95[percnt]CI:0.8­1.02;p=0.024) were inconclusive. Instead we were able find predictors for GIB including long term use of NSAIDs(OR 2.25;95[percnt]CI:1.28­4.69; p<0.001), CCI≥2(OR:4.59; 95[percnt]CI:1.45­1.71; p<0.01), alcohol abuse, atrial fibrillation, gastrostomy. CONCLUSIONS:GIB is relatively known complication in setting of AIS. Decremental trend in recent years does not have any association with chemical or mechanical thrombolysis but instead was predicted by chronic altered metabolic states like NSAID use, alcohol abuse and Atrial fibrillation. Disclosure: Dr. Shah has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Hazra has nothing to disclose. Dr. Lunagariya has nothing to disclose. Dr. Jani has nothing to disclose. Dr. Mehta has nothing to disclose. Dr. Kassab has nothing to disclose. Dr. Hussain has nothing to disclose. Dr. Qureshi has nothing to disclose.