Department of Social Medicine, Asahikawa Medical University, Hokkaido, Japan.
Department of Social Medicine, Asahikawa Medical University, Hokkaido, Japan.
J Stroke Cerebrovasc Dis. 2022 Jul;31(7):106513. doi: 10.1016/j.jstrokecerebrovasdis.2022.106513. Epub 2022 Apr 26.
This study aims to clarify the association between alcohol intake and stroke severity at admission and discharge according to sex and stroke subtype in Japanese patients with acute stroke.
We analyzed the data of 199,599 patients registered in the Japan Stroke Data Bank from 1999 to 2018, including sex, age, stroke subtypes (cardioembolic ischemic, noncardioembolic ischemic, hypertensive hemorrhagic, nonhypertensive hemorrhagic, and subarachnoid hemorrhagic), dates of onset and admission, National Institutes of Health Stroke Scale score at admission, modified Rankin Scale score at discharge, and alcohol intake. Multivariable logistic regression analysis adjusted for stroke-related factors was performed to estimate the odds ratios of alcohol intake for stroke severity.
In cardioembolic ischemic stroke, a significant protective effect of moderate intake on severity at admission was observed in both sexes. In noncardioembolic ischemic stroke, a significant protective effect on stroke severity at admission was found for each sex. At discharge, the results also showed a significant protective effect for each sex with moderate intake. For both subtypes of ischemic stroke, a J-shaped relationship between alcohol intake and stroke severity at admission and discharge was observed in women and men. In hypertensive hemorrhagic stroke, a significant protective effect was found in men at both admission and discharge. In women, heavy drinking had a significant harmful effect on stroke severity at admission.
Habitual alcohol intake is associated with stroke severity at admission and discharge regardless of sex.
本研究旨在明确日本急性脑卒中患者中，根据性别和脑卒中亚型，酒精摄入量与入院时和出院时脑卒中严重程度的关系。
我们分析了 199599 例患者的数据，这些患者来自于 1999 年至 2018 年登记在日本脑卒中数据库中的患者，包括性别、年龄、脑卒中亚型（心源性脑缺血、非心源性脑缺血、高血压性出血性、非高血压性出血性和蛛网膜下腔出血）、发病和入院日期、入院时国立卫生研究院脑卒中量表评分、出院时改良 Rankin 量表评分以及饮酒情况。采用多变量逻辑回归分析调整与脑卒中相关的因素，以估计酒精摄入量与脑卒中严重程度的比值比。
在心源性脑缺血性脑卒中患者中，中度饮酒对入院时严重程度有显著的保护作用，在两性中均如此。在非心源性脑缺血性脑卒中患者中，各性别均观察到中度饮酒对入院时脑卒中严重程度有显著的保护作用。出院时，中度饮酒对各性别也有显著的保护作用。对于缺血性脑卒中的两种亚型，女性和男性均观察到酒精摄入量与入院和出院时脑卒中严重程度之间呈 J 型关系。在高血压性出血性脑卒中患者中，入院和出院时男性均有显著的保护作用。对于女性，大量饮酒对入院时脑卒中严重程度有显著的有害影响。
习惯性饮酒与入院和出院时的脑卒中严重程度有关，无论性别如何。
