Alcohol intake and the risk of intracerebral hemorrhage in the elderly: The MUCH-Italy

Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) Investigators

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding.

METHODS: We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH.

RESULTS: We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95% CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95% CI, 0.77-1.32).

CONCLUSIONS: In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.

Original languageEnglish
JournalNeurology
DOIs
Publication statusE-pub ahead of print - Jun 13 2018

Fingerprint

Cerebral Hemorrhage
Italy
Multicenter Studies
Alcohols
Odds Ratio
Confidence Intervals
Blood Vessels
Age Groups
Stroke
Pathology
Hemorrhage

Cite this

Alcohol intake and the risk of intracerebral hemorrhage in the elderly : The MUCH-Italy. / Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) Investigators.

In: Neurology, 13.06.2018.

Research output: Contribution to journalArticle

Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) Investigators. Alcohol intake and the risk of intracerebral hemorrhage in the elderly: The MUCH-Italy. Neurology. 2018 Jun 13. https://doi.org/10.1212/WNL.0000000000005814
Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) Investigators. / Alcohol intake and the risk of intracerebral hemorrhage in the elderly : The MUCH-Italy. In: Neurology. 2018.
@article{bdf63310dd104e1babef48d7444d0913,
title = "Alcohol intake and the risk of intracerebral hemorrhage in the elderly: The MUCH-Italy",
abstract = "OBJECTIVE: To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding.METHODS: We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH.RESULTS: We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95{\%} confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95{\%} CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95{\%} CI, 0.77-1.32).CONCLUSIONS: In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.",
author = "{Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) Investigators} and Paolo Costa and Mario Grassi and Licia Iacoviello and Marialuisa Zedde and Simona Marcheselli and Giorgio Silvestrelli and DeLodovici, {Maria Luisa} and Maria Sessa and Andrea Zini and Maurizio Paciaroni and Cristiano Azzini and Massimo Gamba and {Del Sette}, Massimo and Antonella Toriello and Carlo Gandolfo and Bonifati, {Domenico Marco} and Rossana Tassi and Anna Cavallini and Alberto Chiti and Calabr{\`o}, {Rocco Salvatore} and Francesco Grillo and Paolo Bovi and Giampaolo Tomelleri and {Di Castelnuovo}, Augusto and Marco Ritelli and Giancarlo Agnelli and {De Vito}, Alessandro and Nicola Pugliese and Giuseppe Martini and Corrado Lodigiani and Andrea Morotti and Loris Poli and {De Giuli}, Valeria and Filomena Caria and Claudio Cornali and {de Gaetano}, Giovanni and Marina Colombi and Alessandro Padovani and Alessandro Pezzini",
note = "{\circledC} 2018 American Academy of Neurology.",
year = "2018",
month = "6",
day = "13",
doi = "10.1212/WNL.0000000000005814",
language = "English",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Alcohol intake and the risk of intracerebral hemorrhage in the elderly

T2 - The MUCH-Italy

AU - Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) Investigators

AU - Costa, Paolo

AU - Grassi, Mario

AU - Iacoviello, Licia

AU - Zedde, Marialuisa

AU - Marcheselli, Simona

AU - Silvestrelli, Giorgio

AU - DeLodovici, Maria Luisa

AU - Sessa, Maria

AU - Zini, Andrea

AU - Paciaroni, Maurizio

AU - Azzini, Cristiano

AU - Gamba, Massimo

AU - Del Sette, Massimo

AU - Toriello, Antonella

AU - Gandolfo, Carlo

AU - Bonifati, Domenico Marco

AU - Tassi, Rossana

AU - Cavallini, Anna

AU - Chiti, Alberto

AU - Calabrò, Rocco Salvatore

AU - Grillo, Francesco

AU - Bovi, Paolo

AU - Tomelleri, Giampaolo

AU - Di Castelnuovo, Augusto

AU - Ritelli, Marco

AU - Agnelli, Giancarlo

AU - De Vito, Alessandro

AU - Pugliese, Nicola

AU - Martini, Giuseppe

AU - Lodigiani, Corrado

AU - Morotti, Andrea

AU - Poli, Loris

AU - De Giuli, Valeria

AU - Caria, Filomena

AU - Cornali, Claudio

AU - de Gaetano, Giovanni

AU - Colombi, Marina

AU - Padovani, Alessandro

AU - Pezzini, Alessandro

N1 - © 2018 American Academy of Neurology.

PY - 2018/6/13

Y1 - 2018/6/13

N2 - OBJECTIVE: To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding.METHODS: We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH.RESULTS: We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95% CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95% CI, 0.77-1.32).CONCLUSIONS: In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.

AB - OBJECTIVE: To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding.METHODS: We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH.RESULTS: We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95% CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95% CI, 0.77-1.32).CONCLUSIONS: In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.

U2 - 10.1212/WNL.0000000000005814

DO - 10.1212/WNL.0000000000005814

M3 - Article

C2 - 29898970

JO - Neurology

JF - Neurology

SN - 0028-3878

ER -