Alcohol overuse and intracerebral hemorrhage: characteristics and long‐term outcome.

Background and purpose: Alcohol overuse (AOu) is considered an important risk factor for spontaneous intracerebral hemorrhage (ICH). The clinical and outcome characteristics of these patients (AOu‐ICH) are not well known. Methods: All patients with ICH admitted to a single university tertiary stroke center were prospectively studied from May 2005 to May 2015. Demographic profiles, radiologic characteristics and clinical outcomes of patients with acute ICH and previous AOu (>40 g/day or >300 g/week) were analyzed. Results: During the study period, 555 patients with spontaneous primary ICH met the inclusion criteria. A total of 81 patients (14.6%) reported AOu (24.3% of men vs. 3.1% of women; P < 0.0001; mean age, 63 years old for AOu vs. 74 years old for non‐AOu; P < 0.0001). Of the classic cardiovascular risk factors, only smoking was associated with AOu (63% vs. 12.2% of non‐AOu; P < 0.0001). Initial severity and hematoma volume were similar in both groups, with no observed differences in stroke care or in‐hospital medical complications. Patients with AOu had worse outcome (modified Rankin Scale score, 3–6 points) than patients without AOu at 3 months [odds ratio (OR), 2.50; 95% confidence interval (CI), 1.32–4.75; P = 0.005] and 12 months (OR, 2.47; 95% CI, 1.23–5.00; P = 0.011). A similar trend was observed at 5 years (OR, 2.48; 95% CI, 0.96–6.39; P = 0.059). Conclusions: Alcohol overuse was present in 14.6% of patients with ICH, who were predominantly male, smokers and a mean of 11 years younger than the non‐AOu group. Despite a lack of differences in initial clinical severity, stroke care and early medical complications, patients with AOu had worse short‐ and long‐term outcomes. [ABSTRACT FROM AUTHOR]