Abstract TMP56: Trends In Alcohol Abuse In Patients With Acute Ischemic Stroke: A 20-year Analysis Of The Nationwide Inpatient Sample

Abstract

Introduction: Heavy alcohol (EtOH) consumption has been long recognized for its damaging effects to the brain and is considered a risk factor for stroke. However, the relationship between EtOH abuse and stroke on in-hospital outcomes remains unclear. Objective: To characterize stroke patients with an EtOH abuse and examine the effects of alcohol abuse on patient outcomes over 20 years. Methods: A query of the 2000-2019 National Inpatient Sample was performed for patients admitted with AIS (ICD9 433, 43401, 43411, 43491, ICD-10 I63). Demographics, comorbidities, and outcomes were identified. Univariate analysis with t-tests or chi-square performed as appropriate. A 1:1 nearest neighbor propensity score matched cohort was generated. Variables with standardized mean differences >0.1 used in multivariate regression to generate adjusted odds ratios (AOR)/β-coefficients for EtOH abuse on outcomes. Significance set at an alpha level of <0.001. All analysis performed in R version 4.1.3. Results: A total of 10,415,286 patients with AIS were identified; 368,953 (3.5%) abused EtOH. EtOH abuse patients had higher Elixhauser Comorbidity Score (11.02 ± 10.38 vs. 9.72 ± 8.76; p<0.001) and NIH Stroke Score (7.19 ± 7.08 vs. 6.65 ± 7.30; p<0.001). Patients with EtOH abuse were more likely to be male, younger, smokers, covered on Medicaid, have atrial fibrillation, and be in the 0-25% percentile median income bracket (all p<0.001). After propensity matching, EtOH abuse patients had longer hospital stay (0.39 days; 95% CI: 0.28-0.5), lower hospital charges (-$3780.6; 95% CI: -$5053.16 - -$2508.04) and were less likely to be discharged home or short-term hospital (AOR 0.83; 95% CI: 0.81-0.85)(all p<0.001). Conclusion: In this 20 year nationally representative propensity matched analysis of patients with AIS, patients that abused EtOH had higher incidences of more severe disease with worse functional outcomes, as well as lower hospital charges despite longer hospital stays.