Occult Blood in Feces Is Associated with a Poor Functional Outcome of Ischemic Stroke Patients Receiving Intravenous Thrombolysis

Min Peng ¹ Xiaoyun Sun ² Xiangling Yuan ^1,3 Chenjuan Tao ⁴ Gelin Xu ^1*

• ¹ Department of Neurology, Shenzhen Institute of Translational Medicine, Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, China
• ² Nanjing Women and Children’s HealthCare Hospital, Nanjing, Liaoning Province, China
• ³ Guangxi University of Chinese Medicine, Nanning, Guangx, China
• ⁴ Department of Neurology, Affiliated Hospital of Hangzhou Normal University, Hangzhou, Jiangsu Province, China

Background: Although fecal occult hemoglobin is commonly valued as a screening tool for colorectal cancer, few studies have examined the clinical significance of fecal immunochemical testing (FIT) in other diseases. This study aimed to explore the association between occult blood in feces and functional outcome of acute ischemic stroke (AIS) patients received intravenous thrombolysis treatment.Methods: Patients diagnosed with acute ischemic stroke and received thrombolytic therapy were enrolled from the neurology department of the Affiliated Hospital of Hangzhou Normal University. FIT was conducted for patients during hospitalization. Functional outcome was assessed by the modified Rankin Scale (mRS). A favorable outcome was defined as mRS 0-2 and a poor outcome as mRS 3-6.Results: 214 patients were included for analysis. The proportion of FIT-positive patients was higher in the poor outcome group than in the favorable group (12.3% vs. 45.6%, P<0.001). Logistic regression models showed that FIT-positive patients had an increased risk of a poor outcome (OR: 4.188, 95% CI: 1.424-11.51, P=0.005) after adjusted possible variables. Moreover, besides gastrointestinal bleeding, NIHSS score at baseline (OR: 1.092, 95% CI: 1.013-1.176, P=0.021) and white blood cells level (OR: 1.215, 95% CI: 1.018-1.448, P=0.031) were also the independent risk factors for positive FIT after thrombolytic therapy in AIS. Conclusion: Positive FIT was related to the poor outcomes in AIS patients who received thrombolytic therapy. High NIHSS score at baseline and high white blood cells levels were the risks of FIT.