S3227 The Risk of Ischemic Cerebrovascular Accident and All-Cause: Mortality Among Patients With Inflammatory Bowel Disease
Bibliographic record
Abstract
INTRODUCTION: Patients with inflammatory bowel disease (IBD) have an increased risk of venous thrombotic events compared to non-IBD population. The risk of arterial thrombotic events in IBD patients is not well characterized. We aim to identify the risk of ischemic cerebrovascular accidents (CVA) in patients with IBD. METHODS: This is a retrospective cohort study utilizing the Agency for Healthcare Research and Quality’s Healthcare cost and Utilization Project National Inpatient Sample (NIS) for the year 2017. We identified patients with a principal diagnosis of ischemic CVA. The exposure of interest was a secondary diagnosis of either Crohn’s disease (CD) or ulcerative colitis (UC). The primary outcome was prevalence of IBD among patients with ischemic CVA. The secondary outcome was in-hospital all-cause mortality. Univariable linear regression analysis was used to calculate unadjusted odds ratios for the primary and secondary outcomes. Multivariable regression models were built by including all confounders that were significantly associated with the outcome on univariable analysis. Significance was defined as the 2-tailed P value of 0.05. RESULTS: Out of 524,045 patients with a diagnosis of acute ischemic CVA, 2,200 (0.41%) had a concurrent diagnosis of IBD. Of these, 905 (0.17%) patients had UC while 1,315 (0.25%) had CD. The overall incidence of IBD among patients with acute ischemic CVA was 0.41%. After adjusting for potential confounders, patients with acute ischemic CVA were less likely to have IBD [OR 0.61 (95% CI: 0.55–0.67), P < 0.01] compared with those who did not have an ischemic CVA. Patients with acute ischemic CVA had significantly lower adjusted odds of CD [OR 0.61, (95% CI: 0.54–0.70), P < 0.01] as well as UC [OR 0.61, (95% CI: 0.53–0.71), P < 0.01] compared with those who did not have acute ischemic CVA. The in-hospital mortality rate among patients with acute ischemic CVA with and without IBD was 4.09% and 4.01%. On multivariate analysis, there was no significant difference in-hospital mortality among patients with acute ischemic CVA with or without IBD [OR 1.07 (95% CI: 0.65–1.76), P = 0.78]. There was no significant difference in mortality on subgroup analysis of patients with UC (OR 0.91, [95% CI: 0.39–2.09], P = 0.82), and CD (OR 1.17, [95% CI: 0.62–2.19], P = 0.62). CONCLUSION: Both UC and CD are not associated with a disproportionately higher risk of ischemic CVA. Cardiovascular risk assessment in IBD patients is important but should be done in the same way as the general population.Table 1.: Baseline characteristics of study populationTable 2.: Co-morbid conditions of subjects in the studyTable 3.: Primary and secondary outcomes of patients admitted to the hospital with ischemic stroke with and without inflammatory bowel disease
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".