Sembill J, Sprügel M, Gerner S, Beuscher VD, Giede-Jeppe A, Stocker M, Lücking H, Kuramatsu J, Huttner H, Hölter P (2018)
Publication Type: Journal article
Publication year: 2018
Book Volume: 27
Pages Range: 892-899
Journal Issue: 4
DOI: 10.1016/j.jstrokecerebrovasdis.2017.10.029
Background: The influence of prior nicotine or alcohol use (legal drug use [LDU]) on outcome measures after intracerebral hemorrhage (ICH) is insufficiently established. We investigated drug-specific associations with (1) neuroradiologic and clinical parameters and (2) functional long-term outcome after ICH. Methods: This observational cohort study analyzed consecutive spontaneous patients with ICH (n = 554) from our prospective institutional registry over a 5-year study period (January 2010 to December 2014). We compared no-LDU patients with LDU patients, and patients using only nicotine, only alcohol, or both. To account for baseline imbalances, we reanalyzed cohorts after propensity score matching. Results: Prevalence of prior LDU was 197 of 554 (35.6%), comprising 94 of 554 (17.0%) with only nicotine use, 33 of 554 (6.0%) with only alcohol use, and 70 of 554 (12.6%) with alcohol and nicotine use. LDU patients were younger (65 [56-73] versus 75 [67-82], P < .01), less often female (n = 61 of 197 [31.0%] versus n = 188 of 357 [52.7%], P < .01), had more often prior myocardial infarction (n = 29 of 197 [14.7%] versus n = 24 of 357 [6.7%], P < .01), and in-hospital complications (sepsis or systemic inflammatory response syndrome: n = 95 of 197 [48.2%] versus n = 98 of 357 [27.5%], P < .01; pneumonia: n = 89 of 197 [45.2%] versus n = 110 of 357 [30.8%], P < .01). Except for an increased risk of pneumonia (odds ratio 2.22, confidence interval [1.04-4.75], P = .04) in patients using both nicotine and alcohol, we detected no significant differences upon reanalysis after propensity score matching of neuroradiologic or clinical parameters, complications, or long-term outcome between patients with and without LDU (mortality: n = 48 of 150 [32.0%] versus n = 45 of 150 [30.0%], P = .71; favorable outcome [modified Rankin Scale 0-3]: n = 56 of 150 [37.3%] versus n = 53 of 150 [35.3%], P = .72). Conclusions: Prior nicotine use, alcohol use, and their combination were associated with significant differences in baseline characteristics. However, adjusting for unevenly balanced baseline parameters revealed no differences in functional long-term outcome after ICH.
APA:
Sembill, J., Sprügel, M., Gerner, S., Beuscher, V.D., Giede-Jeppe, A., Stocker, M.,... Hölter, P. (2018). Influence of Prior Nicotine and Alcohol Use on Functional Outcome in Patients after Intracerebral Hemorrhage. Journal of Stroke and Cerebrovascular Diseases, 27(4), 892-899. https://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.10.029
MLA:
Sembill, Jochen, et al. "Influence of Prior Nicotine and Alcohol Use on Functional Outcome in Patients after Intracerebral Hemorrhage." Journal of Stroke and Cerebrovascular Diseases 27.4 (2018): 892-899.
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