Trends in Substance Abuse Preceding Stroke in Young Adults: An Update (S55.004)

Objective: To reanalyze trends of documented substance abuse among young adults with stroke in the Greater Cincinnati/Northern Kentucky Stroke Study population incorporating our latest data from 2010. Background: We previously reported an increase in substance abuse among stroke patients aged 18 to 55 years from 1993 to 2005. It is important to understand trends in stroke associated with substance abuse, especially given the trend towards increasing stroke in the young. Design/Methods: We identified potential acute stroke events among 18- to 55-year-old residents of the 5 county study region using ICD-9 discharge codes 430-436 during four one-year study periods (7/93-6/94, 1999, 2005, 2010). All events were abstracted by study nurses and then reviewed by physicians to determine case vs. not a case and to classify stroke subtype. Variables of interest were overall substance abuse (combination of current smoking, alcohol, and illicit drug), smoking history (current if present within 3 months of event and past), heavy alcohol consumption, urine/blood test positive for alcohol or illicit drugs at presentation, and illicit drug use. Results: In 2010, for this age group, there were 530 stroke events (80% ischemic). The proportion of whites (66%) and blacks (34%) was similar among study periods. Over the 4 periods, we found significant increases in overall substance abuse (45% to 57%, p<0.01), smoking history (49% to 65%, p<0.01), and use of alcohol or drugs <24 hours prior to stroke onset (1.4% to 15%, p<0.01). Illicit drug use increased significantly in the 35-54 age group (3%-23%, p<0.01), however, we found non-significant increases in current smoking (42% to 48%) and heavy alcohol use (8% to 10%). Conclusions: Substance abuse is an important and highly prevalent risk factor for stroke in young adults. More efforts are needed to curb the increasing relationship between stroke in young adults and illicit drugs, alcohol, and smoking. Study supported by: NIH NINDS grant R01 NS30678 Disclosure: Dr. De Los Rios La Rosa has nothing to disclose. Dr. Kleindorfer has received personal compensation for activities with Genentech, Inc. and for medicolegal case review. Dr. Khoury has nothing to disclose. Dr. Broderick has received research support from Significant, Genentech Inc., and Schering-Plough Corporation, and the National Institute of Neurological Disorders and Stroke. Dr. Alwell has nothing to disclose. Dr. Moomaw has received research support from the National Institutes of Health. Dr. Khatri9s institution has received research support from Penumbra, Inc. and Genentech, Inc. Dr. Adeoye has received personal compensation for activities with Genentech, Inc. Dr. Flaherty has received personal compensation for activities with CSL Behring as a consultant and member of an advisory board. Dr. Flaherty has received research support from the National Institute of Neurological Disorders and Stroke, and Novo Nordisk. Dr. Woo has received research support from the National Institutes of Health. Dr. Eilerman has nothing to disclose. Dr. Ferioli has nothing to disclose. Dr. Kissela has received personal compensation for activities with Allergan Inc. as a consultant and speaker, and Medicolegal Review. Dr. Kissela has received research support from NexStim and Reata Pharmaceuticals.