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Specific Factors Increase Bowel Obstruction Risk in Stroke Inpatients

KANSAS CITY, MO – Which hospitalized ischemic stroke patients are at the highest risk of developing bowel obstruction?

A presentation at the recent American Stroke Association's International Stroke Conference 2016 in Los Angeles provided an answer: Being older, black, and having pre-existing illnesses, such as cancer, all significantly increase the likelihood of the complication.

To better define which hospitalized stroke patients are most at risk of bowel obstruction, University of Missouri Kansas City School of Medicine researchers analyzed a national database of patients hospitalized for acute ischemic stroke from 2002 to 2011 and identified those who also had a diagnosis of bowel obstruction.

Their results indicate that, of the 3,988,667 patients hospitalized for ischemic stroke and identified in the Nationwide Inpatient Sample from 2002-2011, nearly 17,000 had bowel obstruction and 4.2% of them needed repair surgery for intestinal obstruction.

The study notes that factors increasing risk of bowel obstruction include:

  • Advanced age, with stroke patients who were 75 years or older having almost twice the risk of patients younger than 55.
  • Race, with black stroke patients having a 42% higher risk than white stroke patients.
  • Co-morbidities and polypharmacy, with patients having pre-existing illnesses, such as cancer, and taking medications also having an elevated risk.

Being able to identify hospitalized stroke patients likely to develop bowel obstruction is critical because that also makes them more likely to develop deep vein thrombosis, pulmonary embolism, sepsis, acute kidney injury, gastrointestinal hemorrhage, and require blood transfusions, according to the report.

Researchers suggest some of those conditions resulted from increased hospital lengths-of-stay. The occurrence of bowel obstruction in hospitalized stroke patients increased hospital stay and costs by an average of 9.7 days and $22,342, according to the presentation.

The researchers also point out that, compared to ischemic stroke patients without bowel obstruction, those with the condition were nearly three times more likely to suffer moderate to severe disability and 39% more likely to die while inpatients.