Thomas Gattringer1, Christian Enzinger2, Renate Fischer2, Leonhard Seyfang2, Kurt Niederkorn2, Michael Khalil2, Julia Ferrari2, Wilfried Lang2, Michael Brainin2, Johann Willeit2, Franz Fazekas2. 1. From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria. thomas.gattringer@medunigraz.at. 2. From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
Abstract
OBJECTIVE: To determine whether chronic alcohol consumption or acute alcohol intoxication affects the rate of IV thrombolysis (IVT) and associated risk of symptomatic intracranial hemorrhage (SICH) in patients with acute ischemic stroke (IS). METHODS: We analyzed data from the nationwide Austrian Stroke Unit Registry for all patients with IS admitted to one of 35 stroke units between 2004 and 2014. We compared demographic and clinical characteristics for patients with chronic alcohol consumption (>2 drinks/d) or acute intoxication and for patients without these factors and their rates of IVT and associated SICH. RESULTS: We identified 47,422 patients with IS. Of these patients, 3,999 (8.5%) consumed alcohol chronically and 216 (0.5%) presented with acute intoxication. Alcohol abusers were younger, more frequently men, and less often functionally disabled before the index event. Stroke severity was comparable between alcoholic and nonalcoholic IS patients. Nevertheless, patients who abused alcohol were less likely to receive IVT (16.6% vs 18.9%) and this difference remained after accounting for possible confounders. Rates of SICH after IVT were not increased in patients who abused alcohol (2.1% vs 3.7%, p = 0.04). Multivariate analysis including age, NIH Stroke Scale score, and time from symptom onset to IVT treatment showed that alcohol abuse was not an independent risk factor for SICH and was not protective (odds ratio 0.73, 95% confidence interval 0.43-1.25, p = 0.2). CONCLUSIONS: IS patients with chronic alcohol consumption or acute intoxication have decreased likelihood of receiving IVT and are not at an increased risk of associated SICH. This supports current practice guidelines, which do not list chronic alcohol consumption or acute intoxication as an exclusion criterion.
OBJECTIVE: To determine whether chronic alcohol consumption or acute alcohol intoxication affects the rate of IV thrombolysis (IVT) and associated risk of symptomatic intracranial hemorrhage (SICH) in patients with acute ischemic stroke (IS). METHODS: We analyzed data from the nationwide Austrian Stroke Unit Registry for all patients with IS admitted to one of 35 stroke units between 2004 and 2014. We compared demographic and clinical characteristics for patients with chronic alcohol consumption (>2 drinks/d) or acute intoxication and for patients without these factors and their rates of IVT and associated SICH. RESULTS: We identified 47,422 patients with IS. Of these patients, 3,999 (8.5%) consumed alcohol chronically and 216 (0.5%) presented with acute intoxication. Alcohol abusers were younger, more frequently men, and less often functionally disabled before the index event. Stroke severity was comparable between alcoholic and nonalcoholic IS patients. Nevertheless, patients who abused alcohol were less likely to receive IVT (16.6% vs 18.9%) and this difference remained after accounting for possible confounders. Rates of SICH after IVT were not increased in patients who abused alcohol (2.1% vs 3.7%, p = 0.04). Multivariate analysis including age, NIH Stroke Scale score, and time from symptom onset to IVT treatment showed that alcohol abuse was not an independent risk factor for SICH and was not protective (odds ratio 0.73, 95% confidence interval 0.43-1.25, p = 0.2). CONCLUSIONS: IS patients with chronic alcohol consumption or acute intoxication have decreased likelihood of receiving IVT and are not at an increased risk of associated SICH. This supports current practice guidelines, which do not list chronic alcohol consumption or acute intoxication as an exclusion criterion.
Authors: Simon Fandler-Höfler; Rudolf E Stauber; Markus Kneihsl; Gerit Wünsch; Melanie Haidegger; Birgit Poltrum; Alexander Pichler; Hannes Deutschmann; Christian Enzinger; Peter Fickert; Thomas Gattringer Journal: Ther Adv Neurol Disord Date: 2021-08-31 Impact factor: 6.570
Authors: Simon Fandler-Höfler; Markus Kneihsl; Rudolf E Stauber; Egbert Bisping; Harald Mangge; Gerit Wünsch; Melanie Haidegger; Linda Fabisch; Isra Hatab; Peter Fickert; David Werring; Christian Enzinger; Thomas Gattringer Journal: Eur J Neurol Date: 2022-05-24 Impact factor: 6.288