title: Risk of Stroke in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  Observational studies, to date, have provided inconsistent findings on whether inflammatory bowel disease (IBD) is associated with an increased risk of stroke. We therefore performed a meta-analysis to evaluate the association of IBD and its specific subtypes with risk of stroke.
  
  
  METHODS
  We searched electronic databases for studies through May 13, 2015 assessing risk of stroke in patients with IBD. Cohort and case-control studies that reported incident cases of stroke in patients with IBD and a non-IBD control population were eligible. We calculated pooled hazard ratios (HRs) with 95% confidence intervals (CIs).
  
  
  RESULTS
  A total of 8 articles (126,493 IBD patients and 4748 cases of stroke) were included in this meta-analysis. The presence of IBD revealed a trend toward a modest increase in the risk of stroke incidence (HR = 1.29; 95% CI, 1.16-1.43). After subgroup analysis, Crohn's disease showed an increased risk of stroke incidence (7 studies: HR = 1.32; 95% CI, 1.13-1.56), and a significant association was also identified in ulcerative colitis (6 studies: HR = 1.18; 95% CI, 1.06-1.31). In addition, this risk is higher in women (6 studies: HR = 1.49; 95% CI, 1.24-1.79) than in men (HR = 1.22; 95% CI, 1.12-1.32). In the overall analysis we found considerable heterogeneity.
  
  
  CONCLUSIONS
  Our results show a positive association between IBD and the risk of stroke.
authors.affiliation: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Jiangxi Province, China.
authors.forename: Zhilong
authors.initials: Z
authors.lastname: Xiao
authors.affiliation: Schistosomiasis Epidemic Prevention Station of Nanchang County, Nanchang City, Jiangxi Province, China.
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Pei
authors.affiliation: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Jiangxi Province, China.
authors.forename: Min
authors.initials: M
authors.lastname: Yuan
authors.affiliation: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Jiangxi Province, China.
authors.forename: Xueli
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Jiangxi Province, China.
authors.forename: Shenjian
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Neurology, The Second Affiliated Hospital of Nanchang University, Jiangxi Province, China. Electronic address: xulijun20050901@sina.com.
authors.forename: Lijun
authors.initials: L
authors.lastname: Xu
mesh_terms: D005260:Female; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008297:Male; D012306:Risk; D018570:Risk Assessment; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology
keywords: Crohn's disease; Stroke; inflammation bowel disease; meta-analysis; ulcerative colitis