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Prior Cannabis Use Is Associated with Outcome after Intracerebral Hemorrhage
Mario Di Napoli1, Alicia M Zha, Daniel A Godoy
1Neurological Service, San Camillo de' Lellis General Hospital, Rieti, Italy.
Insights
Cannabis use in intracerebral hemorrhage (ICH) patients was associated with milder presentation and better outcomes. This study found that cannabis-positive patients had less disability at discharge, suggesting a potentially protective effect.
Area of Science:
- Neurology
- Toxicology
- Public Health
Background:
- Emerging evidence suggests a link between cannabis use and ischemic stroke.
- The impact of cannabis on intracerebral hemorrhage (ICH) outcomes remains unclear.
Purpose of the Study:
- To investigate the implications of cannabis use in patients diagnosed with spontaneous intracerebral hemorrhage (ICH).
Main Methods:
- Analysis of an international, multicenter observational database of spontaneous ICH patients.
- Data included demographics, risk factors, Glasgow Coma Scale, ICH score, neuroimaging, and urine toxicology screens (UTS).
- Modified Rankin Scale (mRS) assessed outcomes; adjusted logistic ordinal regression analyzed cannabis use impact.
Main Results:
- 8.6% of 725 ICH patients tested positive for cannabinoids via UTS.
- Cannabinoid-positive (CB+) patients were younger, more often Caucasian, and had lower admission ICH scores.
- CB+ patients demonstrated a shift toward better outcomes (lower mRS scores) with an adjusted common OR of 0.544 (p=0.017).
Conclusions:
- Cannabis use was identified in approximately 10% of spontaneous ICH patients in this multinational cohort.
- No association was found between cannabis use and specific ICH characteristics.
- Cannabis-positive patients presented with milder ICH and experienced less disability at discharge.
Objective:
Recent evidence suggests that a potential harmful relationship exists between cannabis use and ischemic stroke. The purpose of this study was to determine the implications of cannabis use in intracerebral hemorrhage (ICH) patients.
Methods:
An analysis of an international, multicenter, observational database of consecutive patients with spontaneous ICH was conducted. We extracted the following characteristics on presentation: demographics, risk factors, antiplatelet or anticoagulant use, Glasgow Coma Scale, ICH score, neuroimaging parameters, and urine toxicology screen (UTS) results. Modified Rankin Scale (mRS) score was utilized for determination of outcome at discharge. Adjusted logistic ordinal regression was used as shift analysis to assess the impact of cannabis use on mRS score at discharge. The adjusted common OR measured the likelihood that cannabis use would lead to lower mRS scores.
Results:
Within a cohort of 725 spontaneous ICH patients, UTS was positive for cannabinoids in 8.6%. Cannabinoids-positive (CB+) patients were more frequently Caucasian (p < 0.001), younger (p < 0.001), and had lower median ICH scores on admission (p = 0.017) than those who were cannabinoids-negative. CB+ patients also showed a shift toward better outcome in the distribution of mRS categories, with an adjusted common OR of 0.544 (95% CI 0.330-0.895, p = 0.017).
Conclusion:
In this multinational cohort, cannabis use was discovered in nearly 10% of patients with spontaneous ICH. Although there was no relationship between cannabis use and specific ICH characteristics, CB+ patients had milder ICH presentation and less disability at discharge.
