University of Cincinnati College of Medicine, Department of Neurology, and Cincinnati Children's Hospital, 260 Stetson St, Suite 2300, Cincinnati, OH 45267, USA.
Stroke. 2012 Dec;43(12):3179-83. doi: 10.1161/STROKEAHA.112.667808. Epub 2012 Nov 15.
Approximately 5% of strokes occur in adults aged 18 to 44 years. Substance abuse is a prevalent risk factor for stroke in young adults. We sought to identify trends in substance abuse detection among stroke patients.
Using a population-based design, we sought to identify all patients aged 18 to 54 years experiencing a stroke (ischemic or hemorrhagic) in the Greater Cincinnati and Northern Kentucky Study region during 1993 to 1994, 1999, and 2005. Demographic and clinical characteristics and substance use data were obtained retrospectively from chart review and adjudicated by physicians.
The number of young patients identified with a stroke increased from 1993 to 1994 (297) to 2005 (501). Blacks (61% vs 51%; P<0.02) and men (61% vs 47%; P<0.002) reported substance abuse (current smoking, alcohol, or illegal drug use) more frequently than did whites and women. Overall use of substances increased across study periods, 45% in 1993 versus 62% in 2005 (P=0.003). The trend was significant for illegal drug use (3.8% in 1993 vs 19.8% in 2005) and ever smoking (49% in 1993 vs 66% in 2005). Documentation of both cocaine and marijuana use increased over time. In 2005, half of young adults with a stroke were current smokers, and 1 in 5 abused illegal drugs.
Substance abuse is common in young adults experiencing a stroke. The observed increase in substance abuse is contributing to the increased incidence of stroke in young adults. Patients aged younger than 55 years who experience a stroke should be routinely screened and counseled regarding substance abuse.
约 5%的中风发生在 18 至 44 岁的成年人中。药物滥用是年轻人中风的一个普遍危险因素。我们试图确定中风患者药物滥用检测的趋势。
使用基于人群的设计，我们试图在 1993 年至 1994 年、1999 年和 2005 年期间，在大辛辛那提和北肯塔基研究地区识别出所有 18 至 54 岁经历中风（缺血性或出血性）的患者。通过病历回顾获取人口统计学和临床特征以及药物使用数据，并由医生进行裁决。
被诊断患有中风的年轻患者人数从 1993 年至 1994 年（297 例）增加到 2005 年（501 例）。黑人（61%比 51%；P<0.02）和男性（61%比 47%；P<0.002）比白人女性更频繁地报告药物滥用（当前吸烟、饮酒或非法药物使用）。研究期间整体药物使用量增加，1993 年为 45%，2005 年为 62%（P=0.003）。非法药物使用（1993 年为 3.8%，2005 年为 19.8%）和曾吸烟（1993 年为 49%，2005 年为 66%）的趋势均具有统计学意义。可卡因和大麻使用的记录随时间增加。2005 年，一半的年轻中风患者是当前吸烟者，1/5 的人滥用非法药物。
药物滥用在经历中风的年轻人中很常见。观察到的药物滥用增加是导致年轻人中风发病率增加的原因。年龄小于 55 岁经历中风的患者应常规进行药物滥用筛查和咨询。
