A case-control study of stroke risk factors and outcomes in African American stroke patients with and without crack-cocaine abuse.
BACKGROUND
Stroke in crack-cocaine abusers is increasingly recognized. We aimed to identify significant differences in stroke risk factors, characteristics, and outcomes between hospitalized stroke patients with and without crack-cocaine abuse.


METHODS
This was a retrospective study that compared stroke patients with crack-cocaine abuse (cases) to stroke patients without crack-cocaine (controls).


RESULTS
We identified 93 crack-cocaine cases and 93 controls admitted between January 2004 and May 2006 to one teaching hospital. There were significant differences between crack-cocaine cases and controls in age (48.7 years vs. 55 years) (P = 0.0001), male gender (65.6% vs. 40.9%) (odds ratios, OR = 1.64, 95% CI 1.22-2.21), arterial hypertension (61.1% vs. 83.9%) (OR = 0.30, 95% CI 0.15-0.60), hypercholesterolemia (18.7% vs. 68.5%) (OR = 0.10, 95% CI 0.05-0.21), diabetes (20.9% vs. 41.9%) (OR = 0.36, 95% CI 0.19-0.70), cigarette smoking (70.6% vs. 29%) (OR = 5.86, 95% CI 3.07-11.20), ischemic stroke (61.3% vs. 79.6%) (OR = 0.40, 95% CI 0.21-0.78), and intracerebral hemorrhage (33.3% vs. 17.2%) (OR = 3.03, 95% CI 1.53-6.00). Also, there were significant differences in National Institutes of Health Stroke Scale scores (3.3 vs. 7) (P < 0.0001), and MRS scores (1.8 vs. 2.5) (P = 0.0022) at hospital discharge. Using univariable and multivariable logistic regression, we found that crack-cocaine abusers had 2.28 higher odds of having a favorable functional outcome (MRS score ≤ 2) at hospital discharge, after adjusting for stroke risk factors and characteristics.


CONCLUSIONS
Our study suggests that crack-cocaine abusers with stroke had fewer traditional risk factors, and more favorable functional outcome as compared to non-crack-cocaine abusers.
Giraldo
Elias A
EA
Department of Neurology, University of Tennessee Health Science Center, 855 Monroe Ave., Room 415, Memphis, TN, 38163, USA, egiraldo@uthsc.edu.
Taqi
Muhammad A
MA
Vaidean
Georgeta D
GD
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology* / Q000208:ethnology; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000208:ethnology; D019970:Cocaine-Related Disorders / Q000453:epidemiology* / Q000208:ethnology; D015331:Cohort Studies; D016578:Crack Cocaine; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia; D006973:Hypertension; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D020521:Stroke / Q000453:epidemiology* / Q000208:ethnology*; D016896:Treatment Outcome
D016578:Crack Cocaine