March 10, 2015

Racial disparities in methamphetamine-associated intracerebral hemorrhage

Kazuma Nakagawa, MD; Megan A. Vento, BS; Marissa M. Ing, MSW; Todd B. Seto, MD, MPH


Objective: To assess racial disparities in the prevalence of methamphetamine-associated intracerebral  hemorrhage (Meth-ICH) among Native Hawaiians and other Pacific Islanders (NHOPI).

Methods: Prospectively collected data from an ongoing, multiethnic, single-center cohort study  were analyzed. The inclusion criteria for the cohort study required that patients be adult (age  18 years or older) residents of Hawaii with nontraumatic spontaneous intracerebral hemorrhage  (ICH). Patients of race other than white, Asian, or NHOPI were excluded. Determination of Meth-  ICH was made prospectively by positive urine toxicology result and lack of other clinically suspected  ICH etiology. Prevalence of Meth-ICH among NHOPI was compared with that of white  and Asian patients.

Results: A total of 193 patients (white 16%, Asian 61%, NHOPI 23%) were analyzed. NHOPI  were younger than white (54 6 15 vs 68 6 15 years,  respectively, p 5 0.0001) and Asian (vs  65 6 16 years, p 5 0.0001) patients. Overall, 25 (13%) Meth-ICHs (mean age: 49 6 6 years,  range: 33–56 years) were identified. NHOPI had higher prevalence of Meth-ICH compared with  white (24% vs 0%, respectively, p 5 0.003) and Asian (vs 12%, p 5 0.046) patients. The  observed age differences between the racial groups persisted even after excluding the Meth-  ICH group (p , 0.01 for all comparison).

Conclusions: NHOPI have higher prevalence of Meth-ICH compared with white and Asian patients.  However, the age disparity is not entirely driven by methamphetamine abuse.

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