Mortality in alcoholics with autonomic neuropathy.

Seventy-nine male chronic alcoholics who had been tested for autonomic neuropathy using four tests of vagus nerve function were followed for up to 7 years (mean 5.5 years). Thirty-two subjects had no vagal neuropathy, 25 had one abnormal test and 22 had two or more abnormal vagal function tests and two of these also had orthostatic hypotension. There were no differences between the reported alcohol consumptions and evidence of central or peripheral nerve or liver damage between the three groups. Twelve patients died during the follow-up period. At 7 years the percentage survival for the subjects with no evidence of vagal neuropathy was 91%, with one abnormal test it was 66% and with two or more abnormal tests it was 79%. The expected percentage survival for each of the group was 94%, 91% and 88% respectively. The results suggest that evidence of vagal neuropathy in chronic alcoholics is associated with a significantly higher mortality than in the general population and that deaths due to cardiovascular disease are a major cause.