title: Heavy alcohol intake and intracerebral hemorrhage: characteristics and effect on outcome.
abstract: OBJECTIVE
  To identify associated factors and influence on long-term outcome of heavy alcohol intake in a large prospective cohort of consecutive patients with a spontaneous intracerebral hemorrhage (ICH).
  
  
  METHODS
  Between November 2004 and March 2009, we prospectively recruited 562 consecutive adults with a spontaneous ICH. We excluded patients without information on drinking habit (n = 22). Heavy alcohol intake was defined as a regular consumption of more than 300 g alcohol/week. We performed bivariate and multivariate analyses (logistic regression) based on demographic and radiologic models. Survival analyses were performed using Kaplan-Meier statistics.
  
  
  RESULTS
  Among 540 patients with ICH, 137 (25) were heavy alcohol drinkers (median age 60 vs 74 years in nonabusers; p < 0.0001). In the multivariate demographic model, heavy alcohol drinkers were less likely to be older (odds ratio [OR] 0.97 per 1-year increase, 95% confidence interval [CI] 0.95-0.98) and to have a history of ischemic heart disease (OR 0.34, 95% CI 0.15-0.77) and more likely to be smokers (OR 3.96, 95% CI 2.43-6.46). In the radiologic model, independent factors were nonlobar location of ICH (OR 1.71, 95% CI 1.05-2.77) and less severe leukoaraiosis (OR 0.76 per 1-step increase, 95%CI 0.62-0.73). Platelet counts and prothrombin ratio were significantly lower among heavy alcohol drinkers (respectively, p = 0.01 and p = 0.017). Heavy alcohol intake was predictive of 2 years mortality only among patients younger than 60 years with nonlobar ICH (hazard ratio 1.96, 95% CI 1.06-3.63).
  
  
  CONCLUSIONS
  Heavy alcohol intake is associated with the occurrence of ICH at a young age. However, the underlying vasculopathy remains unexplored in these patients. Indirect markers suggest small-vessel disease at an early stage that might be enhanced by moderate hemostatic disorders.
authors.affiliation: Department of Neurology, University of Lille Nord de France, UDSL, CHU Lille, EA 1046, Lille, France.
authors.forename: Barbara
authors.initials: B
authors.lastname: Casolla
authors.forename: Nelly
authors.initials: N
authors.lastname: Dequatre-Ponchelle
authors.forename: Costanza
authors.initials: C
authors.lastname: Rossi
authors.forename: Hilde
authors.initials: H
authors.lastname: Hénon
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cordonnier
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000401:mortality; D000437:Alcoholism / Q000453:epidemiology* / Q000401:mortality; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis