Incidence and disease-related risk factors for cerebrovascular accidents in patients with inflammatory bowel diseases: A systematic review and meta-analysis

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Journal of Digestive Diseases Pub Date : 2023-10-05 DOI:10.1111/1751-2980.13232

Jian Wan, Xuan Wang, Yu Jie Zhang, Yue Yin, Zhuo Wang, Xiao Che, Min Chen, Jie Liang, Kai Chun Wu

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Abstract

Objectives

Risk 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.

Methods

PubMed, 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.

Results

Based 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%).

Conclusions

The 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.

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炎症性肠病患者脑血管意外的发病率和疾病相关危险因素：系统综述和荟萃分析。

目的：炎症性肠病（IBD）患者发生脑血管意外（CVA）的风险存在争议，包括溃疡性结肠炎（UC）和克罗恩病（CD）。本研究旨在估计IBD患者CVA的发病率并确定其风险因素。方法：检索PubMed、Embase和Web of Science，直到2023年1月13日，以确定报告IBD患者发生CVA的研究，以及计算CVA的总人年数或相关数据。主要结果是IBD患者CVA的发生率和危险因素。结果：根据对10项研究的分析，IBD患者CVA的合并发病率为2.74（95%CI 1.83-4.10，I2= 99.2%），高于普通人群（发病率比率[IRR]1.21，95%CI 1.09-1.34，I2= 84.8%，p=0.0002）。UC和CD患者的风险也有所增加。IBD患者CVA的风险因素为年龄（不同定义中的显著性）、UC类型（IRR 1.21，95%CI 1.00-1.47，I2= 81.9%，p=0.0499），闪焰（内部收益率1.70，95%置信区间1.36-2.12，I2= 28.7%，第2页= 83.0%，p=0.0010）。结论：IBD患者发生CVA的风险略有增加。应对传统的和IBD相关的危险因素进行管理，以防止IBD患者发生CVA。由于风险因素的影响仅来自2-3项研究的汇总结果，因此需要进一步的研究来证实我们的结果。这篇文章受版权保护。保留所有权利。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Digestive Diseases 医学-胃肠肝病学

CiteScore

5.40

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Digestive Diseases is the official English-language journal of the Chinese Society of Gastroenterology. The journal is published twelve times per year and includes peer-reviewed original papers, review articles and commentaries concerned with research relating to the esophagus, stomach, small intestine, colon, liver, biliary tract and pancreas.