Abstract Details

Title Outcomes Of Acute Ischemic Stroke In Patients With Alcohol Abuse: 10 Year National Estimate

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S47 - Stroke Outcomes and Recurrence (1:33 PM-1:44 PM)

Poster/Presentation
Number 004

Background Excessive alcohol intake is associated with increased risk of stroke. Those with alcohol abuse are also at risk for developing cardiomyopathy, liver disease, anemia and thrombocytopenia.

Objective To evaluate the impact of alcohol use on acute ischemic stroke (AIS0 patients using the Nationwide Inpatient Sample.

Design/Methods We derived our study cohort from Nationwide Inpatient Sample (NIS) database (2005-2014) to identify AIS using appropriate ICD-9CM codes in primary diagnosis field, alcohol abuse by variable “cm alcohol” provided by NIS and Intravascular thrombolysis utilization by procedure code 99.10 in any procedural field. Differences between categorical variables were tested using the chi-square test and continuous variables using the Student t-test.

Results

We identified 4332783 patients with acute ischemic stroke (AIS) in our study group, of which 141113 (3.3%) patients were alcohol abusers. Patients with alcohol abuse and AIS were younger (61 vs. 71.5years; p<0.0001) and predominantly male (80.3%). They were more likely to receive thrombolysis (7.2% vs. 5.7%; p<0.0001) and mechanical thrombectomy (1% vs. 0.7%; p<0.0001). Patients with a history of alcohol abuse and AIS who received thrombolysis had a higher co-morbidity index and were more likely to be treated at a large or teaching hospital. Patient with alcohol abuse also had an increased risk of intracranial bleeding (1% vs. 0.3%; p<0.0001) and major bleeding (10% vs. 3.3%;p<0.0001). Longer median length of stay (5 vs. 4 days; p<0.0001) and higher median cost (17603 vs 9275 dollars; p<0.0001) were also noted. There was increased in-hospital mortality among those alcohol abuse patients who received thrombolysis (6.3% vs. 3.7%; p<0.0001).

Conclusions Patients with alcohol abuse and AIS had a thrombolysis rate of 7.2%. After thrombolysis, they were more prone to develop intracranial bleeding, major bleeding and have in-hospital mortality. The increased rate of bleeding complications may be associated with underlying coagulopathy or decreased liver clearance and platelet dysfunction.

Authors/Disclosures
Weizhe Li, MD, PhD PRESENTER	No disclosure on file
Chirag N. Savani, MD (Tampa General Hospital)	No disclosure on file
	No disclosure on file
Xiyan Yi, MD (Sanford USD Medical center)	Dr. Yi has nothing to disclose.
Tejinder Singh, MD (Reading Hospital- Towerhealth- Division of Neurology)	Dr. Singh has nothing to disclose.
Sukriye Damla Kara, MD (University of Mississippi Medical Center)	Dr. Kara has nothing to disclose.
William S. Burgin, MD	Dr. Burgin has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for VuEssence. Dr. Burgin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Burgin has stock in VuEssence. The institution of Dr. Burgin has received research support from VuEssence. The institution of Dr. Burgin has received research support from Bristol-Myers Squibb. The institution of Dr. Burgin has received research support from ReNeuron.
Swetha Renati, MD (University of South Florida)	Dr. Renati has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ischemia View. Dr. Renati has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. Dr. Renati has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Wettermark Keith, LLC. Dr. Renati has received personal compensation in the range of $500-$4,999 for serving as a Moderator with PRIME ��ɫ��.

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