title: IV thrombolysis in patients with ischemic stroke and alcohol abuse.
abstract: OBJECTIVE
  To determine whether chronic alcohol consumption or acute alcohol intoxication affects the rate of IV thrombolysis (IVT) and associated risk of symptomatic intracranial hemorrhage (SICH) in patients with acute ischemic stroke (IS).
  
  
  METHODS
  We analyzed data from the nationwide Austrian Stroke Unit Registry for all patients with IS admitted to one of 35 stroke units between 2004 and 2014. We compared demographic and clinical characteristics for patients with chronic alcohol consumption (>2 drinks/d) or acute intoxication and for patients without these factors and their rates of IVT and associated SICH.
  
  
  RESULTS
  We identified 47,422 patients with IS. Of these patients, 3,999 (8.5%) consumed alcohol chronically and 216 (0.5%) presented with acute intoxication. Alcohol abusers were younger, more frequently men, and less often functionally disabled before the index event. Stroke severity was comparable between alcoholic and nonalcoholic IS patients. Nevertheless, patients who abused alcohol were less likely to receive IVT (16.6% vs 18.9%) and this difference remained after accounting for possible confounders. Rates of SICH after IVT were not increased in patients who abused alcohol (2.1% vs 3.7%, p = 0.04). Multivariate analysis including age, NIH Stroke Scale score, and time from symptom onset to IVT treatment showed that alcohol abuse was not an independent risk factor for SICH and was not protective (odds ratio 0.73, 95% confidence interval 0.43-1.25, p = 0.2).
  
  
  CONCLUSIONS
  IS patients with chronic alcohol consumption or acute intoxication have decreased likelihood of receiving IVT and are not at an increased risk of associated SICH. This supports current practice guidelines, which do not list chronic alcohol consumption or acute intoxication as an exclusion criterion.
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria. thomas.gattringer@medunigraz.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gattringer
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Enzinger
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Renate
authors.initials: R
authors.lastname: Fischer
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Leonhard
authors.initials: L
authors.lastname: Seyfang
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Niederkorn
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Khalil
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Ferrari
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Lang
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Brainin
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Johann
authors.initials: J
authors.lastname: Willeit
authors.affiliation: From the Department of Neurology (T.G., C.E., R.F., K.N., M.K., F.F.) and Division of Neuroradiology, Department of Radiology (C.E.), Medical University of Graz; Center of Clinical Neurosciences (L.S., M.B.), Danube University of Krems; Department of Neurology (J.F., W.L.), Hospital Barmherzige Brueder Vienna; Department of Neurology (M.B.), University Hospital Tulln; and Department of Neurology (J.W.), Medical University of Innsbruck, Austria.
authors.forename: Franz
authors.initials: F
authors.lastname: Fazekas
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D000435:Alcoholic Intoxication / Q000150:complications*; D000437:Alcoholism / Q000150:complications*; D001317:Austria; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012042:Registries; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D061665:Time-to-Treatment; D016896:Treatment Outcome