CRACK COCAINE USE AND STROKE IN YOUNG-PATIENTS

Background and purpose: Numerous case series have proposed a relations hip between ''crack'' cocaine use and stroke. We performed a retrospec tive case control study at a large inner-city public hospital to deter mine the relationship between crack use and stroke among young persons . Methods: We reviewed records of all patients aged 20 to 39 years wit h a diagnosis of stroke, and of controls selected from patients with n oncocaine-related diagnoses, admitted from January 1990 through June 1 994. We collected information regarding cocaine use, time of last use, route of use, and the results of urine toxicologic studies. We perfor med backward stepwise logistic regression analyses to determine the as sociation of crack use at any time and acute crack use (defined as use within 48 hours prior to presentation) with stroke and stroke subtype s. Results: Among patients with information regarding presence or abse nce of crack use (66 of 144 stroke patients and 99 of 147 controls), c rack use at any time was not associated with stroke (odds ratio [OR] = 0.7, 95% CI 0.4-1.8) or cerebral infarction (OR = 0.5, 95% CI 0.2-1.2 ). Among patients providing temporal information regarding crack use, acute crack use was not associated with stroke (OR = 1.9, 95% CI 0.7-5 .1) or cerebral infarction (OR = 1.2, 95% CI 0.4-3.8). Conclusions: Cr ack use at any time or acute crack use was not significantly associate d with stroke or cerebral infarction in our patient population.