Stroke Patients in an Alcohol Withdrawal State (SPAWS Study) - Clinical Profiles and Functional Outcomes During Hospital Stay in a Tertiary Hospital
Objective:
This study aimed to investigate the association between alcoholic withdrawal (AW) and acute stroke profiles and outcomes through a cross-sectional analysis of patients admitted to a tertiary hospital.
Background:
Patients who experience acute strokes are also at risk of developing a wide range of complications. When these complications coincide with acute alcohol withdrawal syndrome, they can lead to more severe events that may result in death, disability, or delayed recovery.
Design/Methods:
This cross-sectional study included all adult Filipino patients diagnosed with acute ischemic, hemorrhagic stroke, and subarachnoid hemorrhage in an alcohol withdrawal state, admitted from 2018 to 2023 (n=36). Demographic and clinical data, as well as outcomes, were collected through a review of medical records.
Results:
Key findings revealed a male predominance (n=34, 94.44%) among patients, with the majority aged 40-59 years (n=28, 77.78%), and a significant prevalence of hemorrhagic strokes (n=30, 83.33%). Approximately (n=17, 47.22%) of individuals presented with mild alcohol withdrawal symptoms at admission, with (n=20, 55.56%) displaying an alcohol withdrawal timeline ranging from 24 hours to one week. Notably, (n=13, 36.11%) of patients were categorized as having a moderate stroke, as assessed by the NIHSS score. In terms of outcomes, (n=9, 25%) of patients demonstrated no substantial disability, contrasting with a (n=8, 22.22%) mortality rate. (n=20, 55.56%) stayed in the hospital for 1-2 weeks, with at most 1 week (n=27, 75%) of ICU stay. Substantial correlation between the severity of alcohol withdrawal (CIWA-Ar) and functional outcomes (mRS), with a p-value of 0.031, suggesting that heightened withdrawal symptomatology correlates with increased functional impairment.
Conclusions:
The study revealed significant associations between age, gender, alcohol withdrawal timelines, and functional outcome. Furthermore, the correlation between mRS scores and CIWA-Ar components presents a promising predictive tool for improving patient management in this specific population, emphasizing the need for a timely intervention to optimize rehabilitation and recovery.