ArticleFrontiers in medicine2026
Predictive model for in-hospital acute cerebral infarction in patients with acute gastrointestinal bleeding: a retrospective cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute gastrointestinal bleeding (GIB) is a common emergency in gastroenterology and may be accompanied by blood loss, anemia, systemic inflammation, and hemodynamic instability. Because the brain has a high metabolic demand and depends on continuous perfusion and oxygen delivery, patients with GIB may be vulnerable to in-hospital acute cerebral infarction (ACI). However, whether GIB is associated with a higher incidence of in-hospital ACI in gastroenterology inpatients remains insufficiently studied, and clinically practical risk stratification tools are lacking. Objective: To compare the incidence of in-hospital ACI between patients with and without GIB, identify factors associated with in-hospital ACI among patients with GIB, and develop a clinically applicable nomogram. Methods: A retrospective cohort study was conducted among gastroenterology inpatients at Nanchong Central Hospital between September 2020 and December 2025. Patients were classified as GIB or non-GIB. Propensity score matching (PSM) was used to compare in-hospital ACI incidence between groups. Among patients with GIB, candidate predictors were evaluated using univariable and multivariable logistic regression, and a nomogram was developed and internally validated. Sensitivity, alternative, and exploratory subgroup analyses were additionally performed. Results: A total of 2,734 patients with suspected GIB and 10,763 patients without GIB were initially screened; after exclusion, 2,380 and 8,996 patients, respectively, were included. After 1:1 PSM, 2,380 matched pairs were analyzed. In-hospital ACI occurred more frequently in the GIB group than in the non-GIB group (7.8% vs. 5.2%, Conclusion: In this single-center retrospective cohort, GIB was associated with a higher incidence of in-hospital ACI. A six-factor nomogram based on routinely available clinical variables showed good internal performance and may assist risk stratification, although external validation is needed before broader clinical use.
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