PURPOSE: To describe the prevalence of cocaine use in patients admitted with IPH.
METHODS: Retrospective chart review of consecutive patients admitted to a tertiary care center. Inclusion criteria were a diagnosis of non traumatic IPH based on a CT scan and a urine drug screen performed on admission.
RESULTS: We reviewed the charts of 242 consecutive patients admitted to our hospital with a diagnosis of non traumatic IPH, ischemic stroke and subarachnoid hemorrhage from October 2006- October 2008 and sixty one patients met the inclusion criteria of a diagnosis of IPH and urine drug screen on admission and were further analyzed. The majority of the total population were male n=44 (73%) and black n=44 (72%). The mean age was 55 ± 10 yrs. The mean GCS score was 10 ± 4. The mean intracerebral hemorrhage score (ICH) score was 1.47 ± 1.1. Intra ventricular extension was noticed in 35 (57%) of the patients. Only 3 (4%) patients were on anticoagulation. The mean systolic blood pressure (SBP) was 198 ± 45 mmHg with a mean diastolic blood pressure (DBP) of 114 ± 28 mmHg. The median ICU LOS was 4 days (IQR 2-8.5) and median hospital LOS was 8 days (IQR 3-18). Forty four (72%) patients required intubation and mechanical ventilation. Overall hospital mortality was 47.5 %. Urine drug screen for cocaine was positive in 10 of 61 patients (16%). Mean age for cocaine positive patients was 51 ± 7 yrs compared to other patients 55 ± 11 yrs. We did not see any significant difference in ICU LOS, Hospital LOS, Ventilator days, ICH score and mortality. The mean SBP was higher in patients with cocaine use (223 ± 50 vs 193.5 ± 43 mmHg). The DBP was also higher (125 ± 26 vs 112 ± 28 mmHg).
CONCLUSIONS: Cocaine use is prevalent in patients with IPH.
CLINICAL IMPLICATIONS: Patients with IPH should be routinely screened for drug use since the presence of cocaine may have significant clinical implication for BP management with beta blockers.
DISCLOSURE: The following authors have nothing to disclose: Vinny Samuel, Amita Singh, James Cury, Adil Shujaat, Abubakr Bajwa
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