This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objectives: To identify associated factors and influence on long-term outcome of heavy alcohol intake in a large prospective cohort of consecutive patients with a spontaneous intracerebral hemorrhage (ICH).
Methods: Between November 2004 and March 2009, we prospectively recruited 562 consecutive adults with a spontaneous ICH. We excluded patients without information on drinking habit (n = 22). Heavy alcohol intake was defined as a regular consumption of more than 300 g alcohol/week. We performed bivariate and multivariate analyses (logistic regression) based on demographic and radiologic models. Survival analyses were performed using Kaplan-Meier statistics.
Results: Among 540 patients with ICH, 137 (25) were heavy alcohol drinkers (median age 60 vs 74 years in nonabusers; p < 0.0001). In the multivariate demographic model, heavy alcohol drinkers were less likely to be older (odds ratio [OR] 0.97 per 1-year increase, 95% confidence interval [CI] 0.95−0.98) and to have a history of ischemic heart disease (OR 0.34, 95% CI 0.15−0.77) and more likely to be smokers (OR 3.96, 95% CI 2.43−6.46). In the radiologic model, independent factors were nonlobar location of ICH (OR 1.71, 95% CI 1.05−2.77) and less severe leukoaraiosis (OR 0.76 per 1-step increase, 95%CI 0.62−0.73). Platelet counts and prothrombin ratio were significantly lower among heavy alcohol drinkers (respectively, p = 0.01 and p = 0.017). Heavy alcohol intake was predictive of 2 years mortality only among patients younger than 60 years with nonlobar ICH (hazard ratio 1.96, 95% CI 1.06−3.63).
Conclusion: Heavy alcohol intake is associated with the occurrence of ICH at a young age. However, the underlying vasculopathy remains unexplored in these patients. Indirect markers suggest small-vessel disease at an early stage that might be enhanced by moderate hemostatic disorders.
GLOSSARY
- CI=
- confidence interval;
- HR=
- hazard ratio;
- ICH=
- intracerebral hemorrhage;
- IQCODE=
- Informant Questionnaire on Cognitive Decline in the Elderly;
- IQR=
- interquartile range;
- mRS=
- modified Rankin Scale;
- OR=
- odds ratio;
- PITCH=
- Prognosis of InTra-Cerebral Hemorrhage
Footnotes
Study funding: Supported by the University Lille Nord de France (EA 2691, then EA 1046) and ADRINORD (Association pour le Développement de la Recherche et de l'Innovation dans le Nord- Pas de Calais). Dr. Casolla was funded by a Research Fellowship for Young Investigators granted in 2011 by the Italian Foundation Umberto Veronesi.
- Received January 11, 2012.
- Accepted May 1, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
