ISPUB.COM The Internet Journal of Neurology Volume 21 Number 2 DOI: 10.5580/IJN.55191 1 of 7 Association Of Gastrointestinal Bleeding And Clinical Outcome On Acute Ischemic Stroke Patients L Amalia, R Defryanto, A R Ganiem Citation L Amalia, R Defryanto, A R Ganiem. Association Of Gastrointestinal Bleeding And Clinical Outcome On Acute Ischemic Stroke Patients. The Internet Journal of Neurology. 2020 Volume 21 Number 2. DOI: 10.5580/IJN.55191 Abstract Background. Gastrointestinal bleeding is one of the complication of acute ischemic stroke and cause of increased mortality and length of stay. This is caused by a delay in the administration of antiplatelet or anticoagulant.Objective.To find the association between gastrointestinal bleeding with clinical outcome in acute ischemic stroke patient. Methods.This study was a prospective observational, conducted at Hasan Sadikin Hospital Bandung for 4 months (November 2017-February 2018). Acute ischemic stroke patients that fulfill the inclusion and exclusion were observed while being inpatients to observe their mortality and length of stay.This study used univariat, bivariat, multivariat, and stratification analysis. Results. A total of 100 acute ischemic stroke patients were found, and 24 patients had gastrointestinal bleeding. A history of previous peptic ulcer/gastrointestinal bleeding was found most often in patient with gastrointestinal bleeding (20.8%/p=0.003). Median NIHSS score is higher (16 vs 7/p<0.001) and GCS score was lower (12 vs 15/p<0.001) in patients with gastrointestinal bleeding. Multivariate analysis showed that gastrointestinal bleeding were significantly associated with survival (p = 0.021) and length of stay (p = 0.008). The analysis of stratification showed subjects with infections who later experienced gastrointestinal bleeding had a lower risk of death and length of stay than subjects without infection who experienced gastrointestinal bleeding (1.7 vs 22.5 times and 1.5 vs 2 times). Conclusion.Gastrointestinal bleeding had more increased mortality and length of stay than without gastrointestinal bleeding in acute ischemic stroke patient. INTRODUCTION According to data from the World Health Organization (WHO) in 2015, stroke is the number two cause of death in the world after ischemic heart disease. Data from the Health Research and Development Agency of the Indonesian Ministry of Health based on a 2014 survey, strokes occupy the top position of causes of death in Indonesia. Estimated burden of disease (disability, number of sufferers, and death) caused by stroke will increase every year. 1-3 Ischemic stroke is the most common type of stroke, reaching 80% of all stroke events in the world. Outcomes in acute ischemic stroke are affected, among others, by complications that occur, both neurological and non-neurological. There are various non-neurological complications that can occur in patients with acute ischemic stroke, including gastrointestinal bleeding and infection. Gastrointestinal bleeding in patients with acute ischemic stroke is generally in the form of upper gastrointestinal bleeding. Infections that occur in acute ischemic stroke generally are pneumonia and urinary tract infections. Gastrointestinal bleeding has been reported since 1800. 5 In patients with haemorrhagic stroke, gastrointestinal bleeding occurs in about 26.7%, the incidence is related to age and volume of bleeding. 6 The incidence of gastrointestinal bleeding in ischemic stroke patients is lower, ie 0.1 - 8%. The report on the incidence of gastrointestinal bleeding in ischemic stroke in Asia ranges from 1.4 - 7.8% . 7,8 Gastrointestinal bleeding is still a serious problem in both stroke and ischemic stroke. Pathophysiologically, there are different mechanisms for the occurrence of gastrointestinal