Xintong Zhang1,2, Xingshun Qi1, Eric M Yoshida3, Nahum Méndez-Sánchez4, Feifei Hou1, Han Deng1, Xiaoxi Wang1, Jing Qiu5, Chao He5, Shuang Wang5,2, Xiaozhong Guo1. 1. Department of Gastroenterology, Liver Cirrhosis Study Group. 2. Postgraduate College, Fourth Military Medical University, Xi'an, China. 3. Division of Gastroenterology, Vancouver General Hospital, Vancouver, British Columbia, Canada. 4. Liver Research Unit, Medica Sur Clinic and Foundation, Mexico City, Mexico. 5. Department of Neurology, General Hospital of Shenyang Military Area, Shenyang.
Abstract
BACKGROUND AND AIMS: Patients with cirrhosis are reportedly more prone to develop hemorrhagic stroke, thereby increasing the risk of death. However, the effect of ischemic stroke on liver diseases remains unclear. In addition, few studies have explored the risk factors for ischemic stroke in patients with liver cirrhosis. Our study aimed to explore the epidemiology, risk factors, and in-hospital outcomes of ischemic stroke in a large cohort of hospitalized patients with cirrhosis. PATIENTS AND METHODS: In this single-center observational study, we retrospectively reviewed the medical records of patients with liver cirrhosis admitted to our hospital from January 2011 to June 2014. A diagnosis of ischemic stroke was further identified. RESULTS: Of the 2444 patients with liver cirrhosis, 160 had ischemic stroke, including 128 patients with previous ischemic stroke and 32 patients with new-onset ischemic stroke during their hospitalizations. Compared with patients with cirrhosis without ischemic stroke, those with ischemic stroke were significantly older; had a significantly higher proportion of arterial hypertension and a significantly lower proportion of hepatitis B virus infection; had significantly higher white blood cell, platelet, blood urea nitrogen, and triglyceride levels; and had significantly lower alanine aminotransferase and aspartate aminotransferase levels and prothrombin time. The in-hospital mortality was significantly higher in patients with ischemic stroke than in those without [8.80% (14/160) vs. 3.2% (72/2284), P=0.001]. CONCLUSION: Ischemic stroke was often observed in patients with cirrhosis, and it significantly increased the in-hospital mortality. The association of inflammation, coagulation disorders, and viral hepatitis with development of ischemic stroke in liver cirrhosis should be further evaluated in prospective cohort studies.
BACKGROUND AND AIMS: Patients with cirrhosis are reportedly more prone to develop hemorrhagic stroke, thereby increasing the risk of death. However, the effect of ischemic stroke on liver diseases remains unclear. In addition, few studies have explored the risk factors for ischemic stroke in patients with liver cirrhosis. Our study aimed to explore the epidemiology, risk factors, and in-hospital outcomes of ischemic stroke in a large cohort of hospitalized patients with cirrhosis. PATIENTS AND METHODS: In this single-center observational study, we retrospectively reviewed the medical records of patients with liver cirrhosis admitted to our hospital from January 2011 to June 2014. A diagnosis of ischemic stroke was further identified. RESULTS: Of the 2444 patients with liver cirrhosis, 160 had ischemic stroke, including 128 patients with previous ischemic stroke and 32 patients with new-onset ischemic stroke during their hospitalizations. Compared with patients with cirrhosis without ischemic stroke, those with ischemic stroke were significantly older; had a significantly higher proportion of arterial hypertension and a significantly lower proportion of hepatitis B virus infection; had significantly higher white blood cell, platelet, blood ureanitrogen, and triglyceride levels; and had significantly lower alanine aminotransferase and aspartate aminotransferase levels and prothrombin time. The in-hospital mortality was significantly higher in patients with ischemic stroke than in those without [8.80% (14/160) vs. 3.2% (72/2284), P=0.001]. CONCLUSION:Ischemic stroke was often observed in patients with cirrhosis, and it significantly increased the in-hospital mortality. The association of inflammation, coagulation disorders, and viral hepatitis with development of ischemic stroke in liver cirrhosis should be further evaluated in prospective cohort studies.
Authors: Chengming Sun; Lin Zhong; Yanqiu Wu; Chengfu Cao; Danjie Guo; Jie Liu; Lei Gong; Shouxin Zhang; Jun Sun; Yingqi Yu; Weiwei Tong; Jun Yang Journal: Front Cardiovasc Med Date: 2022-05-16
Authors: Michael J Haley; Claire S White; Daisy Roberts; Kelly O'Toole; Catriona J Cunningham; Jack Rivers-Auty; Conor O'Boyle; Conor Lane; Oliver Heaney; Stuart M Allan; Catherine B Lawrence Journal: Transl Stroke Res Date: 2019-12-21 Impact factor: 6.829