Abstract 304: Increased Stroke Severity and Mortality in Methamphetamine Users: A Propensity‐Matched Analysis

Introduction Methamphetamine (meth) is a highly addictive central nervous system stimulant that has been associated with an increased risk of cerebrovascular disease, particularly among younger individuals. Frequent methamphetamine use, defined as meth use exceeding 100 days annually in the United States, has increased by 66% from 2015 to 2019 and represents a growing concern among young patients. This study aims to compare the severity of stroke presentation between methamphetamine users and non‐users by employing propensity score analysis to account for confounding variables. Methods We conducted a retrospective review of consecutive stroke patients who presented to a Comprehensive Stroke Hospital between January 2023 and August 2024 with a definitive diagnosis of ischemic or hemorrhagic stroke. Baseline demographics, clinical presentation, and inpatient mortality were recorded. Patients in the methamphetamine stroke group were matched with non‐methamphetamine stroke patients based on age, gender, hypertension, diabetes mellitus, atrial fibrillation, and hyperlipidemia using propensity score analysis. Statistical analysis was performed using the T‐Test or Mann‐Whitney U‐Test where appropriate. Results Our study included 53 patients with a mean age of 56 (83% ischemic, 17% hemorrhagic) diagnosed with methamphetamine‐related stroke, who were matched to 200 non‐methamphetamine stroke patients with a mean age of 64 (88% ischemic, 12% hemorrhagic) during the study period. The average NIHSS score for meth‐positive patients was higher than that of the meth‐negative group (9.7 vs. 6.5; p=0.05). Meth‐positive patients also had higher white blood cell (WBC) (10 vs 9.3 p=0.03) and neutrophil (7.5 vs. 7.2 p=0.02) counts on presentation. The inpatient mortality rate for meth‐positive patients was significantly higher as well (13.2 vs. 9.5; p=0.02). Conclusion Methamphetamine use among stroke patients is associated with increased stroke severity, WBC count upon presentation, and a higher in‐hospital mortality rate. Future research should investigate the underlying mechanisms that contribute to this increased severity and the implications for treatment outcomes.