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GI Bleeding After Stroke Raises Death Risk
Date:8/6/2008

team tracked makes it difficult to definitively identify what type of stroke patients are at highest risk for GI bleeding -- although that is something he and his colleagues hope to explore down the road. But meanwhile, he argued that the findings already highlight some critical issues concerning stroke recovery.

"One of the key points we want to raise is that people are generally prone to developing medical complications with stroke," he said. "And as part of that larger observation, we know that among these complications are GI issues. And we feel that this is particularly important, because gastrointestinal bleeding is a complication that is potentially modifiable with various treatment strategies."

However, both Dr. Matthew Fink, chief of the division of stroke and critical care neurology at Weill Cornell Medical College in New York City, and Dr. Larry B. Goldstein, director of The Stroke Center at Duke University Medical Center, expressed reservations about the findings.

"Having a poorer outcome in stroke patients with gastrointestinal bleeding is not surprising at all," said Goldstein. "But I don't know, based on this kind of a retrospective study, if we can tell how preventable this is, as there are all sorts of things that the researchers may not be measuring that might affect the results."

Fink agreed, while suggesting that the issue itself is not particularly pressing.

"In the U.S.," he noted, "we treat all our stroke patients with preventive prophylactic therapy to prevent GI bleeding, and our experience is that GI bleeding is a rare event. So, it's really not something we get too concerned about."

"And that means that the fact that this study shows an increased risk of death associated with GI bleeding says to me that a gastrointestinal problem is simply a marker for someone who is a lot sicker, not an independent factor directly related to the stroke itself," he said. "So, I don't think this fi
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