Logo image
Back
Effect of Cigarette Smoking on Functional Outcomes in Patients with Spontaneous Intracerebral Hemorrhage
Journal article   Peer reviewed

Effect of Cigarette Smoking on Functional Outcomes in Patients with Spontaneous Intracerebral Hemorrhage

Natasha Ironside, Ching-Jen Chen, Josephine Pucci and Edward Sander Connolly
Journal of Stroke and Cerebrovascular Diseases, Vol.28(9)
2019
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.06.013

Abstract

Adult Aged Brain Cerebral Hemorrhage Databases, Factual Disability Evaluation Female Health Status Hospital Mortality Humans Male Middle Aged Neuroprotective Agents Nicotine Nicotinic Agonists Non-Smokers Predictive Value of Tests Prognosis Protective Factors Recovery of Function Retrospective Studies Risk Assessment Risk Factors Smokers Smoking Smoking Cessation Time Factors cocaine neuroprotective agent nicotine nicotinic agent adult alcohol consumption Article atrial fibrillation autopsy Barthel index brain hemorrhage cigarette smoking clinical evaluation clinical outcome cohort analysis congestive heart failure coronary artery disease diabetes mellitus diastolic blood pressure ethnicity ex-smoker female functional status assessment Glasgow coma scale glucose blood level hospital mortality human hyperlipidemia independence international normalized ratio major clinical study male middle aged morbidity National Institutes of Health Stroke Scale neuroimaging nonsmoker parenchyma partial thromboplastin time priority journal prothrombin time Rankin scale retrospective study sex spontaneous intracerebral hemorrhage substance use survival systolic blood pressure aged brain brain hemorrhage comparative study convalescence disability drug effect factual database health status mortality pathophysiology predictive value prognosis protection risk assessment risk factor smoking smoking cessation time factor
Background: Nicotine may have neuroprotective effects on the injured brain through modulation of the cholinergic anti-inflammatory pathway. Aims: This study aimed to evaluate the relationship between cigarette smoking and outcomes in patients with spontaneous intracerebral hemorrhage (ICH). Methods: This was a retrospective review of consecutive ICH patients enrolled in the ICH Outcomes Project from 2009 to 2017. Patients with age ≥18 years and baseline modified Rankin Scale (mRS) score 0-2 were included. Smoking patterns were categorized as recent smoker (≤30 days prior to ICH) and not recent smoker (>30 days prior to ICH). Not recent smokers were further categorized into former smokers and nonsmokers. The primary outcome was good outcome (90-day mRS ≤ 2). Secondary outcomes were excellent outcome (90-day mRS 0-1), 90-day Barthel Index, and in-hospital and 90-day mortality. Results: The study cohort comprised 545 patients, including 60 recent smokers and 485 not recent smokers. Recent smokers had higher rates of good (35% versus 23%; odds ratio [OR] = 1.787, P = .047) and excellent (25% versus 13%; OR = 2.220, P = .015) outcomes compared to not recent smokers. These differences were not significant after baseline adjustments. Recent smokers had higher rates of good (36% versus 24%; OR = 1.732, P = .063) and excellent (25% versus 13%; OR = 2.203, P = .018) outcomes compared to nonsmokers. These differences were not significant after baseline adjustments. A 90-day Barthel Index, in-hospital, and 90-day mortality were comparable between recent and not recent smokers, recent and nonsmokers, and former and nonsmokers. Conclusions: Despite potential neuroprotective effects of nicotine found in cigarettes, these may be outweighed by the detrimental effects of cigarette smoking on health outcomes. © 2019 Elsevier Inc.

Metrics

6 Record Views

Details

Logo image