{
  "abstract": "Background: Gastrointestinal complications following aneurysmal subarachnoid hemorrhage (aSAH) are reported using heterogeneous definitions. We systematically reviewed their occurrence, associated factors, and prognostic associations, with meta-analysis restricted to gastrointestinal bleeding incidence.\n\nMethods: Nine databases (PubMed, Embase, Cochrane Library, CINAHL, Web of Science, CNKI, Wanfang, VIP, and SinoMed) were searched from inception to 15 June 2026, without language restrictions. Eligible designs included cohort studies, cross-sectional studies, and case series with separately extractable data for adults with aSAH. Two reviewers independently selected studies, extracted data, and assessed methodological quality using the Newcastle–Ottawa Scale for cohort reports and design-specific JBI checklists for other reports. Study-defined inpatient gastrointestinal bleeding incidence was pooled using a DerSimonian–Laird random-effects model with Freeman–Tukey double-arcsine transformation. Sensitivity analyses varied study inclusion and the statistical model. Other outcomes and associations were synthesized narratively. Certainty of evidence for the pooled incidence was assessed using GRADE.\n\nResults: Sixteen reports were included. Five independent cohort studies involving 2,824 patients and 145 bleeding events yielded a pooled incidence of 4.07% (95% CI 0.52%–10.53%; I ² = 97.74%). Excluding two studies whose definitions included occult blood positivity yielded 2.45% (95% CI 0.43%–5.90%; I ² = 90.67%). A binomial-normal generalized linear mixed model using the same five studies as the primary analysis yielded 2.96% (95% CI 0.79%–9.80%). Reported associations with bleeding included cerebral vasospasm, elevated intracranial pressure, impaired renal function, and treatment modality; these observational findings do not establish causality. Evidence on constipation, diarrhea, composite gastrointestinal dysfunction, and prognosis was limited and heterogeneous. Certainty of evidence for the pooled bleeding incidence was very low.\n\nConclusion: The pooled incidence of gastrointestinal bleeding after aSAH should be interpreted cautiously given the small number of studies, methodological limitations, wide confidence intervals, and persistent heterogeneity. Prospective multicenter studies using standardized outcome definitions and ascertainment methods are needed.\n\nSystematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261425017 , PROSPERO CRD420261425017.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University",
    "Department of Neurosurgical Intensive Care Unit, The Second Affiliated Hospital of Nanchang University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Taohong Wu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Hongping Yang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Minzhi Cao"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Chao Huang"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Ting He"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Yanyan Gong"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7xmtyk18rp9fe.bib",
  "cited_by": 0,
  "doi": "10.3389/fneur.2026.1956555",
  "fulltext_url": null,
  "id": "7xmtyk18rp9fe",
  "issns": [
    "1664-2295"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1956555/full",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-09",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/7xmtyk18rp9fe.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:37Z",
      "native_id": "10.3389/fneur.2026.1956555",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1956555/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1664-2295",
      "subfield": "neurology"
    }
  ],
  "title": "Gastrointestinal complications in patients with aneurysmal subarachnoid hemorrhage: a systematic review with meta-analysis of gastrointestinal bleeding incidence",
  "title_text": "Gastrointestinal complications in patients with aneurysmal subarachnoid hemorrhage: a systematic review with meta-analysis of gastrointestinal bleeding incidence",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:37Z",
  "url": "https://research.draconitic.com/paper/7xmtyk18rp9fe",
  "venue": "Frontiers in Neurology",
  "versions": []
}