Abstract

Background: Acute cerebral infarction (ACI) is a complication of upper gastrointestinal bleeding (UGIB), but the risk factors for ACI in UGIB patients have not been fully explored. The purpose of the current study was to investigate the risk factors for ACI in UGIB patients.

Methods: Upper gastrointestinal bleeding patients admitted to Nanchang University Affiliated Ganzhou Hospital from January 2019 to December 2021 were included. Patients were divided into an ACI group and a non-ACI group according to whether they had a complication of ACI. Propensity score matching was used to match the data between the two groups. The risk factors for ACI in UGIB patients were analyzed by conditional multivariate logistic regression analysis, and receiver operator characteristic (ROC) curves were used to test the performance of risk factors.

Results: There were 1379 UGIB patients included in this study: 50 patients in the ACI group and 1329 patients in the non-ACI group. Forty-eight pairs werematched after propensity scorematching according to sex, age, smoking, drinking, hypertension, coronary heart disease (CHD), diabetes, previous history of cerebral infarction, gout, peptic ulcer, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), and hepatic cirrhosis.  Univariate analysis showed that RBC transfusion was a risk factor for ACI. Compared with middle rate pressure product (RPP) at admission, low RPP and high RPP were risk factors for ACI in UGIB patients. Hemoglobin, mean platelet volume (MPV) and albumin were protective factors for ACI. Conditional multivariate logistic regression showed that red blood cell (RBC) transfusion (OR 3.136, 95% CI 1.711-5.750, p < 0.001)was an independent risk factor for ACI. Compared with middle RPP at admission, low RPP and high RPP were independent risk factors for ACI in UGIB patients. The ROC curve analysis showed that the areas under the curve (AUCs) of the RPP at admission and after RBC transfusion were 0.625 (0.513–0.737, p < 0.05) and 0.688 (0.580-0.795, p < 0.01), respectively.

Conclusions: Compared with middle RPP at admission, low RPP and high RPP were independent risk factors for ACI in UGIB patients, and RBC transfusion was also an independent risk factor for ACI in UGIB patients.