Methamphetamine use is an independent predictor of poor outcome after aneurysmal subarachnoid hemorrhage

Karam Moon, Felipe C. Albuquerque, Mario Mitkov, Andrew F. Ducruet, David A. Wilson, R. Webster Crowley, Peter Nakaji, Cameron McDougall

Research output: Contribution to journalReview article

Abstract

Background: Clinical outcomes of methamphetamine users with aneurysmal subarachnoid hemorrhage (aSAH) are unknown. Objective: To analyze differences in presentation, in-hospital morbidity, and outcomes between methamphetamine users and non-users. Methods: All 472 patients included in the Barrow Ruptured Aneurysm Trial from 2003 to 2007 were reviewed. Patients with 1- and 3-year follow-up were included in this analysis (n=398). Methamphetamine users were identified as patients who provided a history of methamphetamine use on admission or tested positive on urine toxicology testing. Methamphetamine users were compared with non-users using univariate analysis. Outcomes were then analyzed using multivariate logistic regression models for demographic characteristics, medical comorbidities, radiographic and clinical presentation, and vasospasm. Results: Thirty-one patients (7.8%) were identified as methamphetamine users in this cohort. Methamphetamine users were younger than non-users (mean age 42.8 vs 55 years, p<0.001). In multivariate logistic regression models, methamphetamine use was an independent predictor of poor Glasgow Outcome Scale score at both 1 year (OR=5.02; 95% CI 1.03 to 24.48; p<0.05) and 3 years (OR=7.18; 95% CI 1.73 to 29.87; p=0.007). Other independent predictors in this model included older age, clinical vasospasm, diabetes, and aneurysm size. Cocaine and tobacco use were not significantly associated with poor outcome in our cohort. Methamphetamine use was not significantly associated with vasospasm, higher Fisher or Hunt and Hess grade, or intraparenchymal hemorrhage/intraventricular hemorrhage. Conclusions: Methamphetamine users have significantly worse outcomes at 1 and 3 years following aSAH. Further analysis is necessary to understand the pathological response associated with methamphetamine use in this setting.

Original languageEnglish (US)
Pages (from-to)346-350
Number of pages5
JournalJournal of NeuroInterventional Surgery
Volume7
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

Fingerprint

Methamphetamine
Subarachnoid Hemorrhage
Logistic Models
Hemorrhage
Glasgow Outcome Scale
Ruptured Aneurysm
Tobacco Use
Cocaine
Toxicology
Aneurysm
Comorbidity
Demography
Urine
Morbidity

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Methamphetamine use is an independent predictor of poor outcome after aneurysmal subarachnoid hemorrhage. / Moon, Karam; Albuquerque, Felipe C.; Mitkov, Mario; Ducruet, Andrew F.; Wilson, David A.; Crowley, R. Webster; Nakaji, Peter; McDougall, Cameron.

In: Journal of NeuroInterventional Surgery, Vol. 7, No. 5, 01.05.2015, p. 346-350.

Research output: Contribution to journalReview article

Moon, Karam ; Albuquerque, Felipe C. ; Mitkov, Mario ; Ducruet, Andrew F. ; Wilson, David A. ; Crowley, R. Webster ; Nakaji, Peter ; McDougall, Cameron. / Methamphetamine use is an independent predictor of poor outcome after aneurysmal subarachnoid hemorrhage. In: Journal of NeuroInterventional Surgery. 2015 ; Vol. 7, No. 5. pp. 346-350.
@article{30deb0111fd1454086e03b770bb7603b,
title = "Methamphetamine use is an independent predictor of poor outcome after aneurysmal subarachnoid hemorrhage",
abstract = "Background: Clinical outcomes of methamphetamine users with aneurysmal subarachnoid hemorrhage (aSAH) are unknown. Objective: To analyze differences in presentation, in-hospital morbidity, and outcomes between methamphetamine users and non-users. Methods: All 472 patients included in the Barrow Ruptured Aneurysm Trial from 2003 to 2007 were reviewed. Patients with 1- and 3-year follow-up were included in this analysis (n=398). Methamphetamine users were identified as patients who provided a history of methamphetamine use on admission or tested positive on urine toxicology testing. Methamphetamine users were compared with non-users using univariate analysis. Outcomes were then analyzed using multivariate logistic regression models for demographic characteristics, medical comorbidities, radiographic and clinical presentation, and vasospasm. Results: Thirty-one patients (7.8{\%}) were identified as methamphetamine users in this cohort. Methamphetamine users were younger than non-users (mean age 42.8 vs 55 years, p<0.001). In multivariate logistic regression models, methamphetamine use was an independent predictor of poor Glasgow Outcome Scale score at both 1 year (OR=5.02; 95{\%} CI 1.03 to 24.48; p<0.05) and 3 years (OR=7.18; 95{\%} CI 1.73 to 29.87; p=0.007). Other independent predictors in this model included older age, clinical vasospasm, diabetes, and aneurysm size. Cocaine and tobacco use were not significantly associated with poor outcome in our cohort. Methamphetamine use was not significantly associated with vasospasm, higher Fisher or Hunt and Hess grade, or intraparenchymal hemorrhage/intraventricular hemorrhage. Conclusions: Methamphetamine users have significantly worse outcomes at 1 and 3 years following aSAH. Further analysis is necessary to understand the pathological response associated with methamphetamine use in this setting.",
author = "Karam Moon and Albuquerque, {Felipe C.} and Mario Mitkov and Ducruet, {Andrew F.} and Wilson, {David A.} and Crowley, {R. Webster} and Peter Nakaji and Cameron McDougall",
year = "2015",
month = "5",
day = "1",
doi = "10.1136/neurintsurg-2014-011161",
language = "English (US)",
volume = "7",
pages = "346--350",
journal = "Journal of NeuroInterventional Surgery",
issn = "1759-8478",
publisher = "BMJ Publishing Group",
number = "5",

}

TY - JOUR

T1 - Methamphetamine use is an independent predictor of poor outcome after aneurysmal subarachnoid hemorrhage

AU - Moon, Karam

AU - Albuquerque, Felipe C.

AU - Mitkov, Mario

AU - Ducruet, Andrew F.

AU - Wilson, David A.

AU - Crowley, R. Webster

AU - Nakaji, Peter

AU - McDougall, Cameron

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background: Clinical outcomes of methamphetamine users with aneurysmal subarachnoid hemorrhage (aSAH) are unknown. Objective: To analyze differences in presentation, in-hospital morbidity, and outcomes between methamphetamine users and non-users. Methods: All 472 patients included in the Barrow Ruptured Aneurysm Trial from 2003 to 2007 were reviewed. Patients with 1- and 3-year follow-up were included in this analysis (n=398). Methamphetamine users were identified as patients who provided a history of methamphetamine use on admission or tested positive on urine toxicology testing. Methamphetamine users were compared with non-users using univariate analysis. Outcomes were then analyzed using multivariate logistic regression models for demographic characteristics, medical comorbidities, radiographic and clinical presentation, and vasospasm. Results: Thirty-one patients (7.8%) were identified as methamphetamine users in this cohort. Methamphetamine users were younger than non-users (mean age 42.8 vs 55 years, p<0.001). In multivariate logistic regression models, methamphetamine use was an independent predictor of poor Glasgow Outcome Scale score at both 1 year (OR=5.02; 95% CI 1.03 to 24.48; p<0.05) and 3 years (OR=7.18; 95% CI 1.73 to 29.87; p=0.007). Other independent predictors in this model included older age, clinical vasospasm, diabetes, and aneurysm size. Cocaine and tobacco use were not significantly associated with poor outcome in our cohort. Methamphetamine use was not significantly associated with vasospasm, higher Fisher or Hunt and Hess grade, or intraparenchymal hemorrhage/intraventricular hemorrhage. Conclusions: Methamphetamine users have significantly worse outcomes at 1 and 3 years following aSAH. Further analysis is necessary to understand the pathological response associated with methamphetamine use in this setting.

AB - Background: Clinical outcomes of methamphetamine users with aneurysmal subarachnoid hemorrhage (aSAH) are unknown. Objective: To analyze differences in presentation, in-hospital morbidity, and outcomes between methamphetamine users and non-users. Methods: All 472 patients included in the Barrow Ruptured Aneurysm Trial from 2003 to 2007 were reviewed. Patients with 1- and 3-year follow-up were included in this analysis (n=398). Methamphetamine users were identified as patients who provided a history of methamphetamine use on admission or tested positive on urine toxicology testing. Methamphetamine users were compared with non-users using univariate analysis. Outcomes were then analyzed using multivariate logistic regression models for demographic characteristics, medical comorbidities, radiographic and clinical presentation, and vasospasm. Results: Thirty-one patients (7.8%) were identified as methamphetamine users in this cohort. Methamphetamine users were younger than non-users (mean age 42.8 vs 55 years, p<0.001). In multivariate logistic regression models, methamphetamine use was an independent predictor of poor Glasgow Outcome Scale score at both 1 year (OR=5.02; 95% CI 1.03 to 24.48; p<0.05) and 3 years (OR=7.18; 95% CI 1.73 to 29.87; p=0.007). Other independent predictors in this model included older age, clinical vasospasm, diabetes, and aneurysm size. Cocaine and tobacco use were not significantly associated with poor outcome in our cohort. Methamphetamine use was not significantly associated with vasospasm, higher Fisher or Hunt and Hess grade, or intraparenchymal hemorrhage/intraventricular hemorrhage. Conclusions: Methamphetamine users have significantly worse outcomes at 1 and 3 years following aSAH. Further analysis is necessary to understand the pathological response associated with methamphetamine use in this setting.

UR - http://www.scopus.com/inward/record.url?scp=84928250634&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928250634&partnerID=8YFLogxK

U2 - 10.1136/neurintsurg-2014-011161

DO - 10.1136/neurintsurg-2014-011161

M3 - Review article

C2 - 24780822

AN - SCOPUS:84928250634

VL - 7

SP - 346

EP - 350

JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

IS - 5

ER -