Affiliation:
1. State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases Xijing Hospital of Digestive Diseases, Fourth Military Medical University Xi'an Shaanxi Province China
2. Department of Neurology Xijing Hospital, Fourth Military Medical University Xi'an Shaanxi Province China
3. Department of Histology and Embryology School of Basic Medicine, Xi'an Medical University Xi'an Shaanxi Province China
4. Medical School Fourth Military Medical University Xi'an Shaanxi Province China
5. Institute of Infectious Diseases The Fifth Medical Center of PLA General Hospital Beijing China
Abstract
ObjectivesRisk of cerebrovascular accidents (CVAs) in patients with inflammatory bowel disease (IBD) remains inconclusive. In this systematic review and meta‐analysis, we aimed to estimate the incidence of and identify the risk factors for CVA in patients with IBD.MethodsPubMed, EMBASE and Web of Science were searched for articles published up to January 13, 2023 to identify those reported the incidence of CVA in IBD patients, along with the total person‐years or related data to calculate it. The main outcomes were the incidence of and risk factors for CVA in IBD.ResultsBased on the analysis of 10 studies, the pooled incidence of CVA in IBD patients was 2.74 per 1000 person‐years (95% confidence interval [CI] 1.83–4.10 person‐years; I2 = 99.2%), which was higher than that in the general population (incidence rate ratio [IRR] 1.21, 95% CI 1.09–1.34, P = 0.0002; I2 = 84.8%). Risk factors for CVA in IBD patients were age (significance in different definitions), ulcerative colitis (IRR 1.214, 95% CI 1.000–1.474, P = 0.0499; I2 = 81.9%), disease flares (IRR 1.699, 95% CI 1.359–2.122, P < 0.0001; I2 = 28.7%) and chronic activity (IRR 2.202, 95% CI 1.378–3.519, P = 0.0010; I2 = 83.0%).ConclusionsThe risk of CVA modestly increased in IBD patients. Both the traditional and IBD‐related risk factors should be managed to prevent CVA in these patients. Since the effects of risk factors were derived from pooled results of only 2–3 studies, further research is needed to confirm our results.
Funder
National Natural Science Foundation of China