What is the clinical evidence from this study?

Study design: Cohort. Population: Chronic alcoholism with autonomic neuropathy (n=79). Intervention: Vagal neuropathy (abnormal vagus nerve function tests) vs. No vagal neuropathy. Primary outcome: 7-year survival.

What question did this study set out to answer?

Determine whether autonomic neuropathy affecting vagal nerve function increases long-term mortality risk among chronic alcoholics.

April 1, 1988Journal of Neurology Neurosurgery & PsychiatryOpen Access

Mortality in alcoholics with autonomic neuropathy.

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Key result

Vagal neuropathy in chronic alcoholics was associated with lower 7-year survival (66% with 1 abnormal test, 79% with ≥2 abnormal tests) compared to those without vagal neuropathy (91%).

Why the study?

Does the presence of vagal neuropathy increase mortality in male chronic alcoholics?

Population

79 male chronic alcoholics tested for autonomic neuropathy using four tests of vagus nerve function

Comparison

Presence of vagal neuropathy vs No evidence of vagal neuropathy (0 abnormal tests)

Design

Cohort

Follow-up

up to 7 years (mean 5.5 years)

Authors

RJRalph H. JohnsonMedical University of South Carolina BRBrian RobinsonCornell University

Discussion

Member takes

Implication

Vagal neuropathy may flag higher mortality risk in alcoholics; hypothesis-generating for screening or interventions, needs prospective validation.

Key Points

Determine whether autonomic neuropathy affecting vagal nerve function increases long-term mortality risk among chronic alcoholics.
Prospective follow-up of 79 male chronic alcoholics evaluated for autonomic neuropathy using four vagus nerve function tests, followed for up to 7 years (mean 5.5 years).
Participants were categorized into three groups: no vagal neuropathy (n=32), one abnormal test (n=25), and two or more abnormal tests (n=22, including two with orthostatic hypotension).
Twelve patients died during follow-up, yielding 7-year survival rates of 91% for men without vagal neuropathy (expected: 94%), 66% with one abnormal test (expected: 91%), and 79% with two or more abnormal tests (expected: 88%).
Reported alcohol consumption, central or peripheral nerve damage, and liver damage did not differ significantly across groups, indicating vagal neuropathy itself is linked to higher mortality, primarily via cardiovascular complications.

Study Design

Type

Cohort (n=79)

Structured PICO

Does the presence of vagal neuropathy increase mortality in male chronic alcoholics?

Population

79 male chronic alcoholics tested for autonomic neuropathy using four tests of vagus nerve function

Intervention

Presence of vagal neuropathy (1 or ≥2 abnormal vagal function tests)

Comparator

No evidence of vagal neuropathy (0 abnormal tests)

Outcome

Mortality (survival at 7 years)hard clinical

Vagal neuropathy in chronic alcoholics is associated with significantly higher mortality than the general population, largely due to cardiovascular disease.

Cite This Study

Johnson et al. (1988) conducted a cohort in Chronic alcoholism with autonomic neuropathy (n=79). Vagal neuropathy (abnormal vagus nerve function tests) vs. No vagal neuropathy was evaluated on 7-year survival. Vagal neuropathy in chronic alcoholics was associated with lower 7-year survival (66% with 1 abnormal test, 79% with ≥2 abnormal tests) compared to those without vagal neuropathy (91%).

synapsesocial.com/papers/6a0db7ba68ddba849a09dac7 https://doi.org/10.1136/jnnp.51.4.476

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Implication

Vagal neuropathy may flag higher mortality risk in alcoholics; hypothesis-generating for screening or interventions, needs prospective validation.

Mortality in alcoholics with autonomic neuropathy.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Mortality in alcoholics with autonomic neuropathy.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider