Abstract Body: Introduction:
Acute ischemic stroke (AIS) patients are prone to medical complications such as acute kidney injury (AKI), acute myocardial infarction (AMI), deep vein thrombosis (DVT), gastrointestinal bleeding (GIB), pneumonia, pulmonary embolism (PE), sepsis, and urinary tract infection (UTI). Cancer patients are also prone to these complications, but it remains uncertain how the prevalence of medical complications differs between AIS patients with (AIS-C) vs AIS without cancer (AIS-NC).

Methods:
We identified all primary adult (>=18 years) AIS hospitalizations with AIS-C and AIS-NC from the 2016-2019 National Inpatient Sample (NIS). AIS-C were classified as solid (AIS-SC), hematologic (AIS-HC), and metastatic (AIS-MC). We computed the weighted prevalence of complications in various AIS-NC and AIS-C subtypes and used multivariable-adjusted logistic regression models adjusted for age, sex, clinical, and hospital-level factors to compare the odds of complications in AIS-C vs AIS-NC admissions.

Results:
Of 2,037,800 AIS admissions, 0.9% had AIS-HC, 2.3% had AIS-SC, and 1.6% had AIS-MC. The prevalence of any medical complication was lower in AIS-NC (25.6%) vs all AIS subsets: AIS-HC (31.4%), AIS-SC (31.8%), and AIS-MC (43.0%) (figure 1). Thromboembolic complications including AMI, DVT, and PE were particularly prevalent in AIS-MC vs AIS-NC and other AIS-C subtypes (figure 1). After multivariable adjustment, all complications except AKI and UTI were more prevalent in all subsets of AIS-C vs AIS-NC admissions, but these differences were most pronounced for AIS-MC vs AIS-NC admissions. Specifically, AIS-MC admissions had greater odds of AMI (OR 3.10, 95%CI 2.60-3.69), DVT (OR 5.79, 95%CI 4.85-6.92), GIB (OR 2.38, 95%CI 1.78-3.18), PE (OR 7.60, 95%CI 6.10-9.48), pneumonia (OR 2.70, 95%CI 2.18-3.34) and sepsis (OR 1.83, 95%CI 1.41-2.37) compared with AIS-NC. AIS-SC patients had similar odds of UTI vs AIS-NC (OR 1.11, 95%CI 0.98-1.26) and AKI odds (OR 1.01, 95%CI 0.87-1.16) did not differ between AIS-MC vs AIS-NC admissions.

Conclusion:
AIS-C patients, particularly those with AIS-MC have 3-fold the prevalence of AMI, DVT, and PE compared with AIS-MC. Additional measures for preventing these complications in AIS-C are necessary. Pneumonia, sepsis, and GIB are also more prevalent in AIS-C vs AIS-NC, but AKI is just as common in AIS-C vs all subsets of AIS-NC.