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Abstract Details

Illicit Drug Use and Stroke Outcomes: A Case Control Study
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
224
To determine prevalence, mechanism of action, and outcome of stroke with SU.
Illicit substance use (SU) is an important contributor for global disease burden and an increasingly identified risk factor for stroke in young adults. Epidemics, mechanisms of stroke, and outcomes are sparse.
Retrospective chart review of 264 adults hospitalized with acute stroke, including acute ischemic stroke (AIS), intracranial hemorrhage (ICH), and subarachnoid hemorrhage (SAH), between January 2015 and December 2019 with confirmed urine drug screening (UDS) for SU (excluding cannabis, tobacco, and alcohol). Subjects were compared to 525 SU-negative stroke patients during the same timeframe matched for age (± 5 years) and stroke type. Logistic regression was used to compare mortality and disposition outcome, defined as good (home/acute rehabilitation), or poor (subacute rehabilitation/long term care facility/hospice/death).

Out of 5088 acute strokes, 264 (19%) were substance users, of which 53% were AIS, 34% ICH, and 12% SAH. Illicit drugs used were cocaine (70%), opiates (26%), and the rest were amphetamines, phencyclidine, ecstasy, or multiple substances. Subjects in the cohort were younger as compared to controls, [ 55.9±10.6 years vs 64.5±14.61 (p<0.001), men [61% vs 47; (p=0.0007)], and Black [67% vs 44%; p=0.000 )]. AIS etiology was classified as embolic stroke of unknown origin (ESUS) 41% (n=58), cardioembolic 23% (n=33), and small vessel disease 20% (n=29). Hypertension was the leading cause of ICH (n=66). Aneurysmal SAH occurred in 24. SU was associated with no difference in mortality rate among SU and control groups (SU 11.4% vs 14.1%), or poor discharge disposition (29.9% vs 27.3%).
Patients with acute stroke and SU were younger, mainly men and Black. Majority of AIS were ESUS or cardioembolic, while hypertension was the leading cause of ICH. We found no difference in mortality or disposition outcome in our cohort.
Authors/Disclosures
Julianne Hall, MD
PRESENTER 		Dr. Hall has nothing to disclose.
Parneet K. Grewal, MD The institution of Dr. Grewal has received research support from Bristol Myer Squibb Foundation. The institution of Dr. Grewal has received research support from IPSEN Global.
Jeffrey N. Quinn, MD (Cedars Sinai Medical Center) Dr. Quinn has nothing to disclose.
No disclosure on file
Alejandro Vargas, MD, MS, FÂ鶹´«Ã½Ó³»­ (Rush University Medical Center) Dr. Vargas has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer U.S. LLC Pharmaceuticals.
Ivan Da Silva, MD Dr. Da Silva has nothing to disclose.
Rima Dafer, MD (Rush University Medical Center) Dr. Dafer has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Dafer has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Dr. Dafer has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Anderson, Rasor, and partners.