The Deleterious Effects of Methamphetamine Use in Aneurysmal Subarachnoid HemorrhageEric Michael Thompson, MD1, Noah Beadell, MD1, Johnny Delashaw, MD1, Justin Cetas, MD, PhD11Portland, OR United States Keywords: aneurysm, risk factor, outcome, medication, subarachnoid hemorrhage
Methamphetamine use is increasingly common, particularly in younger patients.
The goal of this analysis was to determine if the presentation and outcomes of patients with aneurysmal subarachnoid hemorrhage (SAH) differ in patients who use methamphetamines from those who do not.
Three hundred and seventy-four patients met inclusion criteria. Twenty-eight (7%) had a history of methamphetamine use or positive toxicology. The average age of methamphetamine users was 45.2 and 55.9 in the non-methamphetamine group, p<0.001).
We performed a retrospective review of patients with SAH over the past 6 years. Differences between methamphetamine users and non-users and randomly selected age-matched non-users was determined using Fisher’s exact, chi-squared, and Wilcoxon-Mann-Whitney tests as appropriate.
Methamphetamine users had significantly higher Hunt and Hess grades (3 vs. 2.5, p=0.020; and 3 vs. 2, p<0.001) than non-users and age-matched controls, respectively. Methamphetamine users had significantly higher rates of vasospasm (92.9% vs. 71.1%, p=0.008) than non-users, but there was no difference when compared to age-matched controls (92.9% vs. 89.3%, p=0.500). Methamphetamine users also had significantly lower Glasgow Outcome Scores than age-matched controls (3 vs. 5, p<0.001) but not compared to the entire non-meth user group (3 vs. 4, p=0.170). There was no significant difference in Fisher grade, length of stay, aneurysm location, or presence of multiple aneurysms between the groups.
This is a retrospective study.
Young patients with SAH are likely to have vasospasm regardless of methamphetamine use.
Methamphetamine users have significantly worse presentations and outcomes compared to age-matched controls. Project Roles:
E. Thompson (), N. Beadell (), J. Delashaw (), J. Cetas ()