Abstract
Methamphetamine use has emerged as a risk factor for intracerebral hemorrhage (ICH). We aim to investigate the clinical characteristics and outcomes of methamphetamine-associated ICH (Meth-ICH) versus Non-Meth-ICH. Patients with ICH between January 2011 and December 2017 were studied. Meth-ICH and Non-Meth-ICH were defined by history of abuse and urine drug screen (UDS). The clinical features of the 2 groups were explored. Among the 677 consecutive patients, 61 (9.0%) were identified as Meth-ICH and 350 as Non-Meth ICH. Meth-ICH was more common in Hispanics (14.6%) and Whites (10.1%) as compared to Asians (1.2%). Patients with Meth-ICH were more often younger (51.2 vs. 62.2 years, p < 0.001), male (77.0% vs. 61.4.0%, p < 0.05), and smokers (44.3% vs. 13.4%, p < 0.001). Non-Meth-ICH was more likely to have history of hypertension (72.61% v. 59%, p < 0.05) or antithrombotic use (10.9% vs. 1.6%, p < 0.05). There was no significant difference in clinical severity, hospital length of stay (LOS), rate of functional independence (29.5% vs. 25.7%, p = 0.534), or mortality (18.0% vs. 24.6%, p = 0.267) between the 2 groups. Methamphetamine use was not an independent predictor of poor outcome. Despite difference in demographics, Meth-ICH is similar to Non-Meth ICH in hospital course and outcome.
Highlights
Spontaneous intracerebral hemorrhage (ICH) is a devastating type of strokes[1,2]
Patients with Meth-ICH were identified by recorded history of methamphetamine use or a positive urine drug screen (UDS) at the time of admission
Given the fact that 7.7% of the patients who denied history of methamphetamine use had a positive UDS, the rate of Meth-ICH could be higher if all patients had a UDS
Summary
Spontaneous intracerebral hemorrhage (ICH) is a devastating type of strokes[1,2]. The reported median 30-day mortality ranges from 17% to 40%, with rates of functional independency between 12% and 39%1. Ischemic stroke was subsequently reported to be associated with methamphetamine use as well[10,11,12,13,14] Both population-based study and forensic analysis of fatal strokes showed significant predominance of hemorrhagic strokes in young methamphetamine users[15,16]. Lappin et al performed a systemic review of methamphetamine-related stroke in 2017 and identified 81 hemorrhagic and 17 ischemic stroke cases from case reports and single center series[17]. Both types of stroke were approximately twice as common in males. The objective of this study was to investigate the demographics, hospital course, and outcome of Meth-ICH in comparison to Non-Meth-ICH
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