Published online Dec 18, 2016. doi: 10.4254/wjh.v8.i35.1564
Peer-review started: August 23, 2016
First decision: September 28, 2016
Revised: October 1, 2016
Accepted: November 1, 2016
Article in press: November 2, 2016
Published online: December 18, 2016
To determine the association between cirrhosis and ischemic stroke in a large nationally representative sample.
A retrospective cross-sectional study of all hospitalized patients during 2012 and 2013 in the United States was performed using the National Inpatient Sample database. Hospitalizations with acute stroke, cirrhosis and other risk factors were identified using ICD-9-CM codes.
There were a total of 72082638 hospitalizations in the United States during the years 2012 and 2013. After excluding hospitalizations with missing demographic variables, that there were a total of 1175210 (1.6%) out of these were for acute ischemic stroke. Cirrhosis was present among 5605 (0.4%) cases of ischemic stroke. Mean age among the cirrhotic and non-cirrhotic groups with ischemic stroke were 66.4 and 70.5 years, respectively. Prevalence of risk factors among the two groups was also calculated. After adjusting for various known risk factors the odds of having an ischemic stroke (OR = 0.28, P < 0.001) were 72% lower in cirrhotics compared to non-cirrhotics.
Our study suggests that in a large, nationally representative sample of the United States population, cirrhosis is associated with a lower likelihood of stroke.
Core tip: Our study demonstrates that in a large, nationally representative sample, cirrhosis is associated with a lower likelihood of having an ischemic stroke, after adjusting for known risk factors. Although the odds of having a stroke are lower in cirrhotics, the mortality is significantly higher in them compared to non-cirrhotics.