Alcohol Use Disorder Associated with Worse Prognosis Following Brain Hemorrhage
Surprisingly, Alcohol in the Blood at the Time of Hemorrhage Appeared to Offer Short-term Protection
A new study by New York Medical College (NYMC) faculty and students, published in Acta Neurochirurgica, reveals that patients with alcohol use disorder face markedly worse long-term outcomes after non-traumatic subarachnoid hemorrhage (SAH), a devastating neurological condition often caused by a ruptured aneurysm.
“Alcohol use disorder affects one-in-eight SAH patients, making it critical that clinicians have a greater understanding of how alcohol use disorder, and alcohol use itself, affect patients' prognosis and trajectory,” says Isaac Thorman, SOM Class of 2027, lead author on the study. “While we found that patients with alcohol use disorder had a higher overall risk of death after hemorrhage, some results were unexpected—alcohol use at the time of hemorrhage appeared to have a short-term protective effect. Those with alcohol in their blood at the time of SAH were less likely to die within the first month, and higher alcohol levels appeared to offer greater protection.”
For the population-based, longitudinal study, the researchers identified 216,894 patients with non-traumatic SAH in the TriNetX Research Network and compared patients with alcohol use disorder to patients with no substance use disorders. Of these, 11,648 were tested for alcohol, and 27,079 patients had alcohol use disorder.
“Our research shows that patients with a history of alcohol use disorder are at greater risk for several outcomes after hemorrhage, including long-term diseases of the liver, kidney, and central nervous system,” says Thorman. “A more comprehensive understanding of how alcohol affects outcomes of SAH will help guide clinicians in their management of patients and communication with families.”
This study is part of a three-part series by NYMC researchers that examined outcomes for SAH patients with substance abuse disorders. The first study in the series, published last month in Neurosurgery with Ankita Jain, SOM Class of 2026, and Ellen Huhulea, SOM Class of 2026, as co-first authors, looked at patients with nicotine dependence, and the next study will investigate how other substances—cocaine, amphetamines, opioids, sedatives, and others—may affect the long-term prognosis of patients with SAH.
