Abstract Details

Title Alcohol-Related Hospital Encounters Trigger Stroke Events

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-011

Objective We investigated the impact of alcohol-related emergency department [ED] visits and inpatient hospitalizations on the occurrence of acute ischemic stroke [AIS], intracerebral hemorrhage [ICH], and subarachnoid hemorrhage [SAH]. We also examined the association between alcohol-related encounters and post-stroke outcomes.

Background Few studies have explored alcohol use as a stroke trigger, or examined associations between alcohol use and outcomes after AIS, ICH, and SAH.

Design/Methods The New York State Inpatient and Emergency Department Databases were examined (2006-2013). Validated International Classification of Diseases 9^th edition definitions identified index hospitalizations for AIS, ICH, and SAH; ED visits and hospitalizations for alcohol abuse; and vascular comorbidities. We used case cross-over analysis with conditional logistic regression to estimate odds ratios (OR) for the association between alcohol-related encounters during 3 case periods (30, 60, and 90 days before index event) compared to control periods (exactly 1 year before). Multivariate logistic regression was used to examine the association between exposure to an alcohol-related encounter in the 6 months before index admission and 30-day readmission after discharge from the index AIS, ICH, or SAH hospitalization.

Results 152,356 AIS, 27,257 ICH, and 11,853 SAH index admissions were identified. An alcohol-related encounter within 60, 90, and 120 days before index admission was associated with a higher risk for AIS (OR=1.765, p=0.0081; OR=1.418, p=0.0286; OR=1.287, p=0.0492, respectively). An alcohol-related encounter within 90 days of index admission was associated with SAH (OR=2.375, p=0.0401). ICH was not associated with preceding alcohol-related encounters. An alcohol-related encounter within 6 months before AIS, ICH, and SAH increased the likelihood of 30-day readmission after index admission (AIS: OR=2.542, p<.0001; ICH: OR=2.348, p=0.0131; SAH: OR=3.963, p=0.0005).

Conclusions

In a large US database, we found that alcohol use triggers AIS and SAH, but not ICH. Alcohol-related encounters within 6 months before index admission for AIS, ICH, and SAH resulted in worse outcomes.

Authors/Disclosures
Caroline Gentile Kruse, MD (Hospital of the University of PA) PRESENTER	Dr. Gentile Kruse has nothing to disclose.
Laura K. Stein, MD, MPH (Mount Sinai School of Medicine)	The institution of Dr. Stein has received research support from American Heart Association.
Mandip S. Dhamoon, MD, MPH	Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Faegre Baker Daniels LLP. Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Wellstar Health System Inc. Dr. Dhamoon has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Fabiani Cohen & Hall, LLP. Dr. Dhamoon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Kramer, Dillof, Livingston & Moore. Dr. Dhamoon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Robins Kaplan. Dr. Dhamoon has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Parker Waichman LLP. Dr. Dhamoon has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Heidell, Pittoni, Murphy & Bach, LLP.

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