Intracerebral hemorrhage: who gets tested for methamphetamine use and why might it matter?

Osman, Sahar; Zhu, Zhu; Farag, Mark; Groysman, Leonid; Dastur, Cyrus K.; Akbari, Yama; Stern‐Nezer, Sara; Stradling, Dana; Yu, Wengui

doi:10.1186/s12883-020-01967-y

Cited by 7 publications

(9 citation statements)

References 16 publications

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Section: Resultsmentioning

confidence: 99%

“…15,16 One retrospective study found that male patients with ICH were more likely than female patients with ICH to undergo urine drug screening. 16…”

Section: Resultsmentioning

confidence: 99%

“…14 Conflicting data exist regarding whether Black patients are more likely or not to be screened for drugs of abuse after ICH compared with White patients. 15,16 One retrospective study found that male patients with ICH were more likely than female patients with ICH to undergo urine drug screening. 16 A retrospective single-center study of 265 patients found that providers activated stroke codes less for female patients presenting with ICH to the ED compared with that for male patients.…”

Section: Prehospital and Initial Systems Of Care/diagnostic Assessmentmentioning

confidence: 99%

“…15,16 One retrospective study found that male patients with ICH were more likely than female patients with ICH to undergo urine drug screening. 16 A retrospective single-center study of 265 patients found that providers activated stroke codes less for female patients presenting with ICH to the ED compared with that for male patients. 17 Last, a multivariable analysis of 205 patients from the Genetic and Environmental Risk Factors for Hemorrhagic Stroke study found that Black patients were more likely to be transferred to a tertiary center than non-Black patients presenting to nontertiary EDs.…”

Section: Prehospital and Initial Systems Of Care/diagnostic Assessmentmentioning

confidence: 99%

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Scoping Review of Racial, Ethnic, and Sex Disparities in the Diagnosis and Management of Hemorrhagic Stroke

et al. 2023

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Background and Objectives:In the United States, Black, Hispanic, and Asian Americans suffer from excessively high incidence rates of hemorrhagic stroke compared to White Americans. Women suffer from higher rates of subarachnoid hemorrhage than men. Previous reviews detailing racial, ethnic, and sex disparities in stroke have focused on ischemic stroke. We performed a scoping review of disparities in the diagnosis and management of hemorrhagic stroke in the United States to identify areas of disparities, research gaps, and evidence to inform efforts aimed at health equity.Methods:We included studies published after 2010 that assessed racial and ethnic or sex disparities in the diagnosis or management of patients 18 years or older in the United States with a primary diagnosis of spontaneous intracerebral hemorrhage or aneurysmal subarachnoid hemorrhage. We did not include studies assessing disparities in incidence, risks, or mortality and functional outcomes of hemorrhagic stroke.Results:After reviewing 6161 abstracts and 441 full texts, 59 studies met our inclusion criteria. Four themes emerged. First, few data address disparities in acute hemorrhagic stroke. Second, racial and ethnic disparities in blood pressure control following intracerebral hemorrhage exist and likely contribute to disparities in recurrence rates. Third, racial and ethnic differences in end-of-life-care exist, but further work is required to understand whether these differences represent true disparities in care. Fourth, very few studies specifically address sex disparities in hemorrhagic stroke care.Discussion:Further efforts are necessary to delineate and correct racial, ethnic, and sex disparities in the diagnosis and management of hemorrhagic stroke.

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Section: Resultsmentioning

confidence: 99%

“…15,16 One retrospective study found that male patients with ICH were more likely than female patients with ICH to undergo urine drug screening. 16…”

Section: Resultsmentioning

confidence: 99%

Section: Prehospital and Initial Systems Of Care/diagnostic Assessmentmentioning

confidence: 99%

Section: Prehospital and Initial Systems Of Care/diagnostic Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Scoping Review of Racial, Ethnic, and Sex Disparities in the Diagnosis and Management of Hemorrhagic Stroke

et al. 2023

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“…93.3%, respectively [26]. Cardiomyopathy was defined with reduced left ventricular ejection fraction to 45% or less on clinical echocardiography report [18].…”

Section: Introductionmentioning

confidence: 99%

Cardiomyopathy in patients with acute ischemic stroke and methamphetamine use: Relevance for cardioembolic stroke and outcome

Lee,

Liu,

Blackwill

et al. 2023

Preprint

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Methamphetamine use has emerged as a major risk factor of cardiovascular and cerebrovascular disease in young adults. The aim of this study was to investigate the relevance of methamphetamine use and cardiomyopathy in patients with acute ischemic stroke.We performed a retrospective study of consecutive patients with acute ischemic stroke admitted at our medical center between 2019 and 2022. All patients were screened for methamphetamine use and cardiomyopathy defined as left ventricular ejection fraction ≤ 45%. Methamphetamine use was identified by self-reported history of use and/or positive urine drug screen. Logistic regression model was performed to analyze the relevance of methamphetamine-associated cardiomyopathy and cardioembolic stroke.Among 973 consecutive patients screened for the study, 48 (4.9%) were identified to have methamphetamine use. Compared with Non-meth group (n=892), the patients in the Meth group were significantly younger (53.2 ± 10.0 vs. 69.7 ± 15.2, p <0.001), more likely male (76.6% vs. 50.0%, p <0.001), and associated with significantly higher rate of cardiomyopathy (30.4% vs. 14.0%, p <0.01). They were also less likely to have history of atrial fibrillation (8.7% vs. 33.4%, p<0.01) or hyperlipidemia (28.3% vs. 51.7%, p <0.01). Compared with patients with cardiomyopathy without methamphetamine use, those with methamphetamine use and cardiomyopathy had better functional outcome at 3 months, likely due to younger age and fewer comorbidities. In the logistic regression model, methamphetamine-associated cardiomyopathy was found to be a significant risk factor of cardioembolic stroke (OR 2.88, 95% CI 1.81-4.58, p < 0.0001).Our results demonstrate that methamphetamine use increases the risk of cardiomyopathy and cardioembolic stroke in young adults.

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The impact of sex and gender on advanced stroke interventions and end-of-life outcomes after stroke

Comer,

Jawed,

Roeder

et al. 2024

Journal of Stroke and Cerebrovascular Diseases

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Intracerebral hemorrhage: who gets tested for methamphetamine use and why might it matter?

Cited by 7 publications

References 16 publications

Scoping Review of Racial, Ethnic, and Sex Disparities in the Diagnosis and Management of Hemorrhagic Stroke

Scoping Review of Racial, Ethnic, and Sex Disparities in the Diagnosis and Management of Hemorrhagic Stroke

Cardiomyopathy in patients with acute ischemic stroke and methamphetamine use: Relevance for cardioembolic stroke and outcome

The impact of sex and gender on advanced stroke interventions and end-of-life outcomes after stroke

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