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APHA Scientific Session and Event Listing

Arthur Westover, MD, Dept. of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, 214-448-9419, anwestover@yahoo.com, Susan McBride, RN, PhD, Data Initiative, Dallas - Fort Worth Hospital Council, 250 Decker Drive, Irving, TX 75062, and Robert Haley, MD, Dept. of Internal Medicine, Division of Epidemiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8874.

Abuse of stimulant drugs is increasing in the western United States. Although case reports and animal studies suggest a link with stroke, epidemiologic studies have yielded conflicting results. Objective. To test the hypothesis that young adults who abuse amphetamines or cocaine are at higher risk for stroke. Design. Using a cross-sectional design and from a quality indicators database of 3,148,165 discharges from Texas hospitals, we estimated the secular trends from 2000 to 2003 in abuse of various drugs and of strokes. We developed separate logistic regression models of risk factors for hemorrhagic (N=937) and ischemic (N=998) stroke discharges of persons 18 to 44 years of age in 2003, and for mortality risk in patients with stroke. Outcome Measure. Incidence of stroke using definitions from the Agency for Healthcare Research and Quality's stroke mortality inpatient quality indicator. Results. From 2000 to 2003 the rate of increase was greatest for abuse of amphetamines. The rate of strokes also increased, particularly among amphetamine abusers. In 812,247 discharges in 2003, amphetamine abuse was associated with hemorrhagic stroke (adjusted odds ratio [OR], 4.95; 95% confidence interval [CI], 3.24 to 7.55) but not with ischemic stroke; cocaine abuse was associated with both hemorrhagic (OR, 2.33; 95% CI, 1.74 to 3.11) and ischemic stroke (OR, 2.03; 95% CI, 1.48 to 2.79). Amphetamine abuse, but not cocaine abuse, was associated with a higher risk of death after hemorrhagic stroke. Increases in stimulant drug abuse may increase the rate of hospital admissions for strokes as well as stroke-related mortality.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Articulate the risks of stroke in amphetamine and cocaine abusers.
• Describe issues surrounding use of discharge databases to analyze outcomes.

Keywords: Substance Abuse, Strokes

Presenting author's disclosure statement:

Not Answered