Prestroke Alcohol Consumption and Smoking Are Not Associated with Stroke Severity, Disability at Discharge, and Case Fatality

Fekete, Klára; Szatmári, Szabolcs; Szôcs, Ildikó; Szekeres, Csilla; Szász, József Attila; Mihálka, László; Smolanka, Volodymyr; Kardos, Lászĺo; Csiba, László; Bereczki, Dániel

doi:10.1016/j.jstrokecerebrovasdis.2013.08.006

Cited by 16 publications

(22 citation statements)

References 29 publications

(47 reference statements)

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“…Some studies found, in accordance with our results, a higher risk of in-hospital pneumonia for patients with high alcohol intake and no clear association with stroke severity and short-term mortality. 6,30 It could by hypothesized that the negative physiological effects of an unhealthy lifestyle would have an adverse effect on the patient's ability to overcome a stroke; however, the lack of an association between an unhealthy lifestyle and an increased risk of early phase adverse clinical outcome found in our study do not support this hypothesis. This may reflect that the physiological consequences of an unhealthy lifestyle on stroke outcomes are truly negligible; however, it may also reflect a possible survival bias, where patients with an unhealthy lifestyle surviving long enough to experience a stroke may be less susceptible to the potential adverse effects that the lifestyle may have in the early phase after the stroke.…”

Section: Discussioncontrasting

confidence: 75%

“…[3][4][5][6][7][8][9][10] In addition, most of the existing studies have not been population based and have often been conducted in specialized units which raise concerns about the generalizability of the findings. There is consequently a need for large-scale studies on unselected patients in order better to comprehend the impact of lifestyle on stroke outcomes, including stroke severity, the risk of important medical complications, and mortality in acute stroke care settings.…”

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confidence: 99%

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Lifestyle Factors and Early Clinical Outcome in Patients With Acute Stroke

Ingeman

Andersen

Thomsen

et al. 2017

Stroke

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2 ), smoking habits, and alcohol intake, which were grouped (healthy, moderately healthy, moderately unhealthy, and unhealthy). The associations between lifestyle and outcomes were examined using multivariable regression. Results-A total of 18.3% had a severe stroke, 7.8% pneumonia, 12.5% urinary tract infection, and 9.9% died within 30 days. The association between lifestyle, stroke severity, and mortality, respectively, differed according to sex. However, underweight may be a particular concern being associated with an increased risk of adverse outcomes among both sexes.

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Section: Discussioncontrasting

confidence: 75%

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confidence: 99%

Lifestyle Factors and Early Clinical Outcome in Patients With Acute Stroke

Ingeman

Andersen

Thomsen

et al. 2017

Stroke

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“…Heavy alcohol consumption is well-known risk factor for stroke (49,50), but the relationship between the risk of recurrent stroke and alcohol consumption remains unknown, especially in China. Alcohol consumption independently predicted impairment 2 years after stroke in one study (51), but no association with functional outcomes after stroke was found in other studies (52)(53)(54). In this study, ever drinking was an independent risk factor for recurrence in the overall population and among elderly stroke patients at both 1 and 5 years after the initial stroke.…”

Section: Discussioncontrasting

confidence: 71%

Rate and Determinants of Recurrence at 1 Year and 5 Years After Stroke in a Low-Income Population in Rural China

Han

Mao

et al. 2020

Front. Neurol.

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Recurrent stroke is becoming an increasingly important public health issue owing to the increased risk of disability and death. However, population-based studies investigating the rate of recurrent stroke in China are rare. We explored the rate and determinants of recurrent stroke within 1 and 5 years after the initial stroke in a rural population in China. Data for stroke events were obtained from the Tianjin Brain Study, conducted between 1992 and 2016. The age-standardized rates of recurrent stroke within the first year and the first 5 years after the initial stroke were calculated for this period. Determinants of recurrent stroke were assessed using Cox regression analyses. The overall age-standardized rate of recurrent stroke within 1 year was 5.7% (men, 6.9%; women, 4.6%); within 5 years, the overall recurrent stroke rate was 22.5% (men, 24.0%; women, 20.2%). The recurrence rate increased with advancing age and decreased with increased educational attainment. Age ≥65 years and a history of alcohol consumption were independent risk factors for recurrent stroke within 1 year after the incident stroke, after adjusting for age, sex, education, hypertension, diabetes, smoking, and alcohol consumption. However, the risk of recurrent stroke within 5 years after the incident stroke was positively associated with male sex, age ≥65 years, a lower level of education, known diabetes, and alcohol consumption, after adjusting for the previously indicated covariates. These findings suggest a crucial need to address risk factor management among stroke patients to reduce the burden of stroke, especially among low-income populations. Furthermore, a multicenter, large sample, nationwide study is urgently needed.

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“…Currently, active smoking is a recognized risk factor for stroke, with 12.4% of accidental stroke patients attributable to current smoking [4]. Studies have found that pre-stroke smoking has a negative or neutral effect on the prognosis of stroke [5][6][7][8][9][10][11][12]. But recent studies reported the so-called "smoker's paradox", suggesting that smokers who undergo thrombolytic therapy have better clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

“Smoking paradox” is not true in patients with ischemic stroke: a systematic review and meta-analysis

Liu

et al. 2019

J Neurol

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Background Ischemic stroke (IS) is a common cause of death from vascular diseases. Studies have found that smoking increases the risk of ischemic stroke, but the association of smoking with the outcome of IS remains unclear. This metaanalysis aims to investigate the effect of smoking on the prognosis of IS. Methods We searched four electronic databases including PubMed, EMBASE, Cochrane library and Web of science for papers, published before January 2019. In this meta-analysis, Review Manager 5.3 software was used to calculate for the pooled estimate effect, as well as the inverse-variance method for pooled mean difference (MD) and odds ratio (OR) of incidence in two groups of population. Results A total of 14,789 citations were identified during the literature search, 21 studies were included in the meta-analyses after screening. The full-adjusted OR of poor prognostic outcome in smoking and nonsmoking patients with stroke was pooled as 0.96 (95% CI 0.77-1.21), suggested that smoking or not has no impact on prognosis of IS. The pooled MD of onset age between smoking and nonsmoking IS patients was − 10.05 (− 12.91, − 7.19), indicated that smoking causes first onset of IS to occur 10 years earlier. Conclusions This meta-analysis showed that smoking was not a protective factor for poor prognosis of IS. Smoking patients with IS are 10 years younger than nonsmoking patients at time of the first onset of stroke.

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Prestroke Alcohol Consumption and Smoking Are Not Associated with Stroke Severity, Disability at Discharge, and Case Fatality

Cited by 16 publications

References 29 publications

Lifestyle Factors and Early Clinical Outcome in Patients With Acute Stroke

Lifestyle Factors and Early Clinical Outcome in Patients With Acute Stroke

Rate and Determinants of Recurrence at 1 Year and 5 Years After Stroke in a Low-Income Population in Rural China

“Smoking paradox” is not true in patients with ischemic stroke: a systematic review and meta-analysis

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