Clinical characteristics and outcomes of methamphetamine-associated intracerebral hemorrhage

Dionne E. Swor, Matthew B. Maas, Sandeep S. Walia, David P. Bissig, Eric M. Liotta, Andrew M. Naidech, Kwan Ng

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To compare the clinical characteristics and outcomes of primary intracerebral hemorrhage (ICH) with and without methamphetamine exposure. METHODS: We performed a retrospective analysis of patients diagnosed with spontaneous, nontraumatic ICH over a 3-year period between January 2013 and December 2016. Demographics, clinical measures, and outcomes were compared between ICH patients with positive methamphetamine toxicology tests vs those with negative methamphetamine toxicology tests. RESULTS: Methamphetamine-positive ICH patients were younger than methamphetamine-negative ICH patients (52 vs 67 years, p < 0.001). Patients with methamphetamine-positive ICH had higher diastolic blood pressure (115 vs 101, p = 0.003), higher mean arterial pressure (144 vs 129, p = 0.01), longer lengths of hospital (18 vs 8 days, p < 0.001) and intensive care unit (ICU) stay (10 vs 5 days, p < 0.001), required more days of IV antihypertensive medications (5 vs 3 days, p = 0.02), and had more subcortical hemorrhages (63% vs 46%, p = 0.05). The methamphetamine-positive group had better premorbid modified Rankin Scale (mRS) scores (p < 0.001) and a greater change in functional ability as measured by mRS at the time of hospital discharge (p = 0.001). In multivariate analyses, methamphetamine use predicted both hospital length of stay (risk ratio [RR] 1.54, confidence interval [CI] 1.39-1.70, p < 0.001) and ICU length of stay (RR 1.36, CI 1.18-1.56, p < 0.001), but did not predict poor outcome (mRS 4-6). CONCLUSIONS: Methamphetamine use is associated with earlier age at onset of ICH, longer hospital stays, and greater change in functional ability, but did not predict outcome.

Original languageEnglish (US)
JournalNeurology
Volume93
Issue number1
DOIs
StatePublished - Jul 2 2019

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Methamphetamine
Cerebral Hemorrhage
Length of Stay
Toxicology
Intensive Care Units
Odds Ratio
Confidence Intervals
Age of Onset
Antihypertensive Agents
Arterial Pressure
Multivariate Analysis
Demography
Outcome Assessment (Health Care)
Hemorrhage
Blood Pressure
Hypertension

ASJC Scopus subject areas

  • Clinical Neurology

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Swor, D. E., Maas, M. B., Walia, S. S., Bissig, D. P., Liotta, E. M., Naidech, A. M., & Ng, K. (2019). Clinical characteristics and outcomes of methamphetamine-associated intracerebral hemorrhage. Neurology, 93(1). https://doi.org/10.1212/WNL.0000000000007666

Clinical characteristics and outcomes of methamphetamine-associated intracerebral hemorrhage. / Swor, Dionne E.; Maas, Matthew B.; Walia, Sandeep S.; Bissig, David P.; Liotta, Eric M.; Naidech, Andrew M.; Ng, Kwan.

In: Neurology, Vol. 93, No. 1, 02.07.2019.

Research output: Contribution to journalArticle

Swor, Dionne E. ; Maas, Matthew B. ; Walia, Sandeep S. ; Bissig, David P. ; Liotta, Eric M. ; Naidech, Andrew M. ; Ng, Kwan. / Clinical characteristics and outcomes of methamphetamine-associated intracerebral hemorrhage. In: Neurology. 2019 ; Vol. 93, No. 1.
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AU - Swor, Dionne E.

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AU - Walia, Sandeep S.

AU - Bissig, David P.

AU - Liotta, Eric M.

AU - Naidech, Andrew M.

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N2 - OBJECTIVE: To compare the clinical characteristics and outcomes of primary intracerebral hemorrhage (ICH) with and without methamphetamine exposure. METHODS: We performed a retrospective analysis of patients diagnosed with spontaneous, nontraumatic ICH over a 3-year period between January 2013 and December 2016. Demographics, clinical measures, and outcomes were compared between ICH patients with positive methamphetamine toxicology tests vs those with negative methamphetamine toxicology tests. RESULTS: Methamphetamine-positive ICH patients were younger than methamphetamine-negative ICH patients (52 vs 67 years, p < 0.001). Patients with methamphetamine-positive ICH had higher diastolic blood pressure (115 vs 101, p = 0.003), higher mean arterial pressure (144 vs 129, p = 0.01), longer lengths of hospital (18 vs 8 days, p < 0.001) and intensive care unit (ICU) stay (10 vs 5 days, p < 0.001), required more days of IV antihypertensive medications (5 vs 3 days, p = 0.02), and had more subcortical hemorrhages (63% vs 46%, p = 0.05). The methamphetamine-positive group had better premorbid modified Rankin Scale (mRS) scores (p < 0.001) and a greater change in functional ability as measured by mRS at the time of hospital discharge (p = 0.001). In multivariate analyses, methamphetamine use predicted both hospital length of stay (risk ratio [RR] 1.54, confidence interval [CI] 1.39-1.70, p < 0.001) and ICU length of stay (RR 1.36, CI 1.18-1.56, p < 0.001), but did not predict poor outcome (mRS 4-6). CONCLUSIONS: Methamphetamine use is associated with earlier age at onset of ICH, longer hospital stays, and greater change in functional ability, but did not predict outcome.

AB - OBJECTIVE: To compare the clinical characteristics and outcomes of primary intracerebral hemorrhage (ICH) with and without methamphetamine exposure. METHODS: We performed a retrospective analysis of patients diagnosed with spontaneous, nontraumatic ICH over a 3-year period between January 2013 and December 2016. Demographics, clinical measures, and outcomes were compared between ICH patients with positive methamphetamine toxicology tests vs those with negative methamphetamine toxicology tests. RESULTS: Methamphetamine-positive ICH patients were younger than methamphetamine-negative ICH patients (52 vs 67 years, p < 0.001). Patients with methamphetamine-positive ICH had higher diastolic blood pressure (115 vs 101, p = 0.003), higher mean arterial pressure (144 vs 129, p = 0.01), longer lengths of hospital (18 vs 8 days, p < 0.001) and intensive care unit (ICU) stay (10 vs 5 days, p < 0.001), required more days of IV antihypertensive medications (5 vs 3 days, p = 0.02), and had more subcortical hemorrhages (63% vs 46%, p = 0.05). The methamphetamine-positive group had better premorbid modified Rankin Scale (mRS) scores (p < 0.001) and a greater change in functional ability as measured by mRS at the time of hospital discharge (p = 0.001). In multivariate analyses, methamphetamine use predicted both hospital length of stay (risk ratio [RR] 1.54, confidence interval [CI] 1.39-1.70, p < 0.001) and ICU length of stay (RR 1.36, CI 1.18-1.56, p < 0.001), but did not predict poor outcome (mRS 4-6). CONCLUSIONS: Methamphetamine use is associated with earlier age at onset of ICH, longer hospital stays, and greater change in functional ability, but did not predict outcome.

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