Prestroke alcohol consumption and smoking are not associated with stroke severity, disability at discharge, and case fatality

Abstract

Background: Heavy alcohol consumption and smoking are known risk factors for stroke, but their influence on stroke severity and outcome may also be important. We tested if alcohol consumption and smoking relate to initial stroke severity, disability at discharge from hospital, and outcome at 30 days and at 1 year in 1049 patients of the Mures-Uzhgorod-Debrecen database.

Methods: Initial stroke severity was scored by the National Institutes of Health Stroke Scale. Case fatality and the modified outcome scale of the First International Stroke Trial were used to assess outcome. We used multiple regression analysis.

Results: Before their stroke, 24.5% were smokers and 24.7% admitted regular alcohol consumption. Neither smoking nor alcohol consumption status was associated with initial stroke severity. Case fatalities at discharge, at 30 days, and at 1 year were 12.2%, 16.9%, and 28.3%, respectively. Initial stroke severity, hemorrhagic subtype, and age in men over 60 years were strong predictors of outcome. We did not find significant difference among alcohol consumers and nonconsumers in 30-day and in 1-year case fatality in all stroke patients and in ischemic stroke patients. In hemorrhagic stroke, there was a nonsignificant tendency for higher case fatality among alcohol consumers (39.5% versus 26.4%, P > .2, at 30 days and 48.8% versus 35.8%, P > .2, at 1 year). Smoking did not influence significantly the outcome at 30 days and at 1 year.

Conclusion: Despite being risk factors, prestroke smoking and alcohol consumption do not have a significant influence on stroke severity and on short- and long-term outcome.

Keywords: Stroke; alcohol; outcome; severity; smoking.