Abstract Details

Title Socioeconomic and Racial Disparities in Stimulant Drug Use-associated Stroke: Trends in Mortality, Hospitalization, and Resource Use

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-020

Objective To quantify trends in U.S. stroke hospitalizations involving stimulant drug abuse from 2016-2022 and to compare patient characteristics, in-hospital mortality, resource utilization, and discharge disposition to non-users.

Background Stimulant drug use(SDU) disorder associated stroke is a growing public health concern, linked to a substantially increased risk of hemorrhagic events. However, comprehensive national trends and outcomes in the contemporary era of rising stimulant drug abuse is not reported at national level.

Design/Methods A retrospective cohort study using the National Inpatient Sample (2016-2022) identified adult acute ischemic and hemorrhagic stroke hospitalizations. Stimulant drug use was flagged by ICD-10 codes. Multivariable logistic, generalized linear, and multinomial logistic regression models analyzed trends and outcomes, adjusting for patient demographics, comorbidities, and hospital-level factors.

Results Among 4,366,799 stroke hospitalizations (2016-2022), 97,630 (2.24%) involved stimulant use, increasing from 1.77% to 2.76% (aOR 1.08/year, 95%CI 1.07-1.10, p<0.001). Stimulant-associated strokes occurred in younger patients (53.8 vs 69.7 years), predominantly males (68.5% vs 50.4%), with higher proportions of Black patients (39.0% vs 17.1%), Medicaid coverage (45.7% vs 9.6%), and lowest income quartile (48.5% vs 30.1%). Hemorrhagic strokes were disproportionately higher with stimulant use (30.6% vs 20.9%, p<0.001), particularly with methamphetamine (33.5%). After full adjustment, stimulant use independently increased mortality (aOR 1.25, 95%CI 1.12-1.40, p<0.001) with adjusted probabilities of 8.1% vs 6.6%. Length of stay was 17% longer (aRR 1.17, 95%CI 1.11-1.22, p<0.001; adjusted means 7.19 vs 5.93 days). Hospital charges averaged $124,300 vs $86,900 (unadjusted), with significant temporal growth (aRR 1.063/year, p<0.001). Disposition patterns showed 65% higher likelihood of leaving against medical advice (RRR 1.65, 95%CI 1.38-1.98, p<0.001), increase tendency of this behavior (interaction RRR 1.07/year, p=0.003) as compared to discharge to home (RRR 0.74, 95%CI 0.68-0.80, p<0.001).

Conclusions Stroke associated with SDU affecting young, socioeconomically disadvantaged populations, with increased hemorrhagic risk, mortality and healthcare utilization, indicate need for early behavioral interventions.

Authors/Disclosures
Muhammad Ahmed, MD (Medical College of Georgia, Augusta University) PRESENTER	Dr. Ahmed has nothing to disclose.
Muhammad Zohaib Qasim, MD	Dr. Qasim has nothing to disclose.
Hafiz M. Maaz (Quaid-e-Azam Medical College, Bahawalpur Pakistan)	Mr. Maaz has nothing to disclose.
Muhammad Tayyab Muzaffar Chaychi, MD	Muhammad Tayyab Muzaffar Chaychi, MD has nothing to disclose.
Muhammad Sohaib, MBBS	Mr. Sohaib has nothing to disclose.
Rawdah Shakil, MBBS	Ms. Shakil has nothing to disclose.

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