{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:20:37Z","timestamp":1753881637451,"version":"3.41.2"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The United States is experiencing a rapidly increasing rate of opioid drug abuse. Intravenous drug use (IVDU)\u2010related endocarditis can lead to significant neurological complications with high morbidity and mortality. When patient care necessitates anticoagulation, the standards for radiographic screening and the risk for intracranial hemorrhage are not clearly elucidated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">We conducted a retrospective cohort study involving patients treated for infective endocarditis at a single institution from 2014 to 2018. Patients were grouped based in history of IVDU and their demographics and clinical predictors for intracranial hemorrhage were analyzed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 351 patients met inclusion criteria for this study, of whom 170 patients (48%) had a history of IVDU\u2010associated endocarditis. IVDU was associated with an increased prevalence of intracranial hemorrhage (25.9% versus 13.9%;\n              <jats:italic>P<\/jats:italic>\n              =0.005), including intraparenchymal hemorrhage (12.4% versus 5.1%;\n              <jats:italic>P<\/jats:italic>\n              =0.012), subarachnoid hemorrhage (17.6 versus 4.4%;\n              <jats:italic>P<\/jats:italic>\n              =0.001), and cerebral microbleeds (14.1% versus 7.2%;\n              <jats:italic>P<\/jats:italic>\n              =0.022). IVDU was also associated with an increased incidence of infectious intracranial aneurysm (10.6% versus 1.8%;\n              <jats:italic>P<\/jats:italic>\n              =0.001) and brain abscesses (4.7% versus 1.1%;\n              <jats:italic>P<\/jats:italic>\n              =0.025). Multivariate analysis showed that the presence of intracranial septic emboli (odds ratio [OR], 18.47 [8.4\u201340.250];\n              <jats:italic>P<\/jats:italic>\n              =0.001) and infectious intracranial aneurysm (OR, 12.38 [3.24\u201347.28];\n              <jats:italic>P<\/jats:italic>\n              =0.001) as significant predictive factors for intracranial hemorrhage after presenting with endocarditis.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">The opioid epidemic has increased the incidence of infective endocarditis and resultant neurovascular complications. IVDU\u2010associated endocarditis is associated with increased hemorrhagic stroke and more frequent neurodiagnostic imaging.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.122.000806","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T11:20:14Z","timestamp":1687605614000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Intravenous Drug Use\u2010Associated Endocarditis Leads to Increased Intracranial Hemorrhage and Neurological Comorbidities"],"prefix":"10.1161","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1678-3583","authenticated-orcid":false,"given":"Alex N.","family":"Hoang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery The Ohio State University Wexner Medical Center Columbus OH"},{"name":"Department of Neurosurgery Houston Methodist Hospital Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varun","family":"Shah","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine Columbus OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Granger","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Ohio State University Wexner Medical Center Columbus OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Dornbos","family":"III","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Kentucky Lexington KY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick P.","family":"Youssef","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Ohio State University Wexner Medical Center Columbus OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciaran J.","family":"Powers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Ohio State University Wexner Medical Center Columbus OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Tanweer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Baylor College of Medicine Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise D.","family":"McCullough","sequence":"additional","affiliation":[{"name":"Department of Neurology McGovern Medical School Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahid M.","family":"Nimjee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Ohio State University Wexner Medical Center Columbus OH"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm675152e1"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1016\/j.athoracsur.2019.07.041","article-title":"Cardiac surgery in patients with opioid use disorder: an analysis of 1.7 million surgeries","volume":"109","author":"Shah RM","year":"2020","unstructured":"Shah RM, Hirji SA, Percy E, Shah RM, Hirji SA, Percy E, Landino S, Yazdchi F, Bellavia A, Pelletier MP, et\u00a0al. Cardiac surgery in patients with opioid use disorder: an analysis of 1.7 million surgeries. Ann Thorac Surg. 2020;109:1194\u20101201.","journal-title":"Ann Thorac Surg"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"2905","DOI":"10.1007\/s10096-012-1675-x","article-title":"Infective endocarditis in intravenous drug abusers: an update","volume":"31","author":"Sousa C","year":"2012","unstructured":"Sousa C, Botelho C, Rodrigues D, Azeredo J, Oliveira R. Infective endocarditis in intravenous drug abusers: an update. Eur J Clin Microbiol. 2012;31:2905\u20102910.","journal-title":"Eur J Clin Microbiol"},{"key":"e_1_3_2_5_2","article-title":"Mycotic aneurysm detection rates with cerebral angiography in patients with infective endocarditis","volume":"7","author":"Hui FK","year":"2014","unstructured":"Hui FK, Bain M, Obuchowski NA, Gordon S, Spiotta AM, Moskowitz S, Toth G, Hussain S. Mycotic aneurysm detection rates with cerebral angiography in patients with infective endocarditis. J Neurointerv Surg. 2014;7:neurintsurg\u20102014\u2010011124.","journal-title":"J Neurointerv Surg"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.07.060"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X14557152"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118616"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000331475"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2008.603"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.024436"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(06)70631-4"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000010054"}],"container-title":["Stroke: Vascular and Interventional Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/SVIN.122.000806","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T15:34:39Z","timestamp":1715614479000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/SVIN.122.000806"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":12,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1161\/SVIN.122.000806"],"URL":"https:\/\/doi.org\/10.1161\/svin.122.000806","relation":{},"ISSN":["2694-5746"],"issn-type":[{"type":"electronic","value":"2694-5746"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"2022-12-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e000806"}}