Study Finds Alcohol Withdrawal (AW) Linked to Poorer Outcomes in Acute Ischemic Stroke (AIS)
Proactive management and intervention of AW complications leads to reduction in mortality and associated hospital costs
Dr. Seemant Chaturvedi, Stewart J. Greenebaum Endowed Professor in Stroke Neurology at the University of Maryland School of Medicine and Director of the Stroke Division at the University of Maryland Medical Center supervised a recent study examining the association of alcohol abuse (AA) and alcohol withdrawal (AW) with outcomes for acute ischemic stroke (AIS) patients. Currently, AA is a widespread epidemic in the United States with proportions increasing over the last decade and often denotes an increased risk of AIS.
With the heightened need for alcohol abstinence during acute illnesses and hospitalizations, patients with alcohol use disorder including those with AIS, are predisposed to AW syndrome – which can lead to an increase in morbidity and mortality among hospital stays. AIS is a leading cause of disability and among the top causes of mortality in the country, therefore, early modifications during such hospital stays are necessary to reduce complications overall as well as costs and length of stay.
The study evaluated all adult AIS admissions in the United States from 2004 to 2014 (based on data obtained from the National Inpatient Sample (NIS), maintained as part of the Health Care Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ). Of the AA admissions, 10.6% of patients, representing 0.4% of all AIS, developed AW. The prevalence of AA and AW in AIS increased by 45.2% and 40.0% respectively, over time. Comparatively, AIS admissions with AW were more likely to acquire additional complications including urinary tract infection, pneumonia, sepsis, gastrointestinal bleeding, deep venous thrombosis, and acute renal failure as well as increased mortality compared to those without AW. Moreover, AW was associated with a roughly 15-day increase in length of stay and about $5,000 increase in hospitalization cost.
To avoid increased costs, longer hospitalizations, and higher statistical possibility of complications and mortality after AIS, it is necessary to implement proactive management of AW to improve outcomes in these patients.
Learn more about stroke care at University of Maryland Medical Center's Comprehensive Stroke Center.