Objective:

To evaluate the occurrence of in-hospital ACI among individuals with and without GIB, determine the variables linked to in-hospital ACI in patients experiencing GIB, and create a clinically relevant nomogram to enhance risk stratification in clinical practice.

Key Findings:

• In-hospital ACI was more frequent in the GIB cohort (7.8%) compared to the non-GIB cohort (5.2%).
• Independent predictors of in-hospital ACI in the GIB population included antecedent cerebral infarction, sepsis, cerebral hemorrhage, anemia, age, and duration of hospital admission.
• The nomogram demonstrated strong internal performance with an AUC of 0.864, based on a total of 2,380 matched pairs.

Interpretation:

GIB is associated with a higher incidence of in-hospital ACI, and the developed nomogram can assist in risk stratification for affected patients, potentially improving clinical outcomes.

Limitations:

• Single-center study may limit generalizability and introduce biases.
• External validation of the nomogram is necessary before clinical application.

Conclusion:

The study establishes a link between GIB and increased in-hospital ACI incidence, with a clinically useful nomogram for risk assessment pending further validation to ensure its applicability in broader clinical settings.