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Role of Helicobacter pylori in Upper Gastrointestinal Bleeding Among Ischemic Stroke Hospitalizations: A Nationwide Study of Outcomes

1
Department of Neurology, Creighton University School of Medicine, Omaha, NE 68122, USA
2
Department of Internal Medicine, University of Nevada Reno School of Medicine, Las Vegas, NV 89102, USA
3
Department of Rehabilitation Medicine, Metropolitan Hospital Center, New York, NY 10029, USA
4
Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, PA 19129, USA
5
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
*
Author to whom correspondence should be addressed.
Gastrointest. Disord. 2019, 1(3), 358-371; https://0-doi-org.brum.beds.ac.uk/10.3390/gidisord1030029
Received: 29 June 2019 / Revised: 29 August 2019 / Accepted: 30 August 2019 / Published: 3 September 2019
Introduction: Helicobacter pylori (H. pylori) is a well-recognized risk factor for upper gastrointestinal bleeding (UGIB). The exposure to tissue plasminogen activator (tPA), anti-platelets, and anticoagulants increases the risk of UGIB in acute ischemic stroke (AIS) patients, the risk stratification of H. pylori infection is not known. In this retrospective cross-sectional study, we aimed to evaluate the relationship between H. pylori and GIB in patients hospitalized with AIS. Methods: In the nationwide data, hospitalization for AIS was identified by primary diagnosis using International Classification of Diseases, clinical modification (ICD-9-CM) codes. Subgroup of patients with GIB and H. pylori were identified in AIS cohort. A stepwise multivariable logistic regression model was fitted to evaluate the outcome of upper GIB and role of H. Pylori in UGIB. Results: Overall 4,224,924 AIS hospitalizations were identified, out of which 18,629 (0.44%) had UGIB and 3122 (0.07%) had H. pylori. The prevalence of H. pylori-induced UGIB among UGIB in AIS was 3.05%. The prevalence of UGIB was markedly elevated among the H. pylori infection group (18.23% vs. 0.43%; p < 0.0001) compared to the non-H. pylori group. In multivariable regression analysis, H. pylori was associated with markedly elevated odds of UGIB (aOR:27.75; 95%CI: 21.07–36.55; p < 0.0001). Conclusion: H. pylori infection had increased risk-adjusted occurrence of UGIB amongst the AIS hospitalized patients. H. pylori testing may improve risk stratification for UGIB and lower the health care cost burden in stroke hospitalization. View Full-Text
Keywords: acute ischemic stroke; helicobacter pylori; gastrointestinal hemorrhage; tissue plasminogen activator; nationwide inpatient sample; gastrointestinal bleeding acute ischemic stroke; helicobacter pylori; gastrointestinal hemorrhage; tissue plasminogen activator; nationwide inpatient sample; gastrointestinal bleeding
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MDPI and ACS Style

Patel, U.K.; Dave, M.; Lekshminarayanan, A.; Patel, N.; Lunagariya, A.; Jani, V.; Dhamoon, M.S. Role of Helicobacter pylori in Upper Gastrointestinal Bleeding Among Ischemic Stroke Hospitalizations: A Nationwide Study of Outcomes. Gastrointest. Disord. 2019, 1, 358-371. https://0-doi-org.brum.beds.ac.uk/10.3390/gidisord1030029

AMA Style

Patel UK, Dave M, Lekshminarayanan A, Patel N, Lunagariya A, Jani V, Dhamoon MS. Role of Helicobacter pylori in Upper Gastrointestinal Bleeding Among Ischemic Stroke Hospitalizations: A Nationwide Study of Outcomes. Gastrointestinal Disorders. 2019; 1(3):358-371. https://0-doi-org.brum.beds.ac.uk/10.3390/gidisord1030029

Chicago/Turabian Style

Patel, Urvish K., Mihir Dave, Anusha Lekshminarayanan, Nidhi Patel, Abhishek Lunagariya, Vishal Jani, and Mandip S. Dhamoon. 2019. "Role of Helicobacter pylori in Upper Gastrointestinal Bleeding Among Ischemic Stroke Hospitalizations: A Nationwide Study of Outcomes" Gastrointestinal Disorders 1, no. 3: 358-371. https://0-doi-org.brum.beds.ac.uk/10.3390/gidisord1030029

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