Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
    • Education
  • Online Sections
    • Neurology Video Journal Club
    • Inclusion, Diversity, Equity, Anti-racism, & Social Justice (IDEAS)
    • Innovations in Care Delivery
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

April 30, 2013; 80 (18) Article

Urine toxicology screening in an urban stroke and TIA population

Brian Silver, Daniel Miller, Michelle Jankowski, Nawaf Murshed, Patricia Garcia, Patricia Penstone, Melissa Straub, Sean P. Logan, Anita Sinha, Daniel C. Morris, Angelos Katramados, Andrew N. Russman, Panayiotis D. Mitsias, Lonni R. Schultz
First published April 17, 2013, DOI: https://doi.org/10.1212/WNL.0b013e318293e2fe
Brian Silver
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Daniel Miller
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michelle Jankowski
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nawaf Murshed
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Patricia Garcia
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Patricia Penstone
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Melissa Straub
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sean P. Logan
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anita Sinha
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Daniel C. Morris
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Angelos Katramados
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Andrew N. Russman
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Panayiotis D. Mitsias
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lonni R. Schultz
From the Department of Neurology (B.S.), Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI; Departments of Neurology (D.M., N.M., P.P., D.C.M., A.K., P.D.M.) and Public Health Sciences Research (M.J., L.R.S.), Henry Ford Hospital, Detroit, MI; Mount Carmel Neurology East (P.G.), Columbus, OH; Georgetown University School of Medicine (M.S.), Washington, DC; Department of Family Medicine (S.P.L.), Oakwood Hospital, Detroit; Department of Anesthesiology (A.S.), Saint Joseph Mercy Hospital, Ann Arbor, MI; and Department of Neurology (A.N.R.), Cleveland Clinic, Cleveland, OH.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Urine toxicology screening in an urban stroke and TIA population
Brian Silver, Daniel Miller, Michelle Jankowski, Nawaf Murshed, Patricia Garcia, Patricia Penstone, Melissa Straub, Sean P. Logan, Anita Sinha, Daniel C. Morris, Angelos Katramados, Andrew N. Russman, Panayiotis D. Mitsias, Lonni R. Schultz
Neurology Apr 2013, 80 (18) 1702-1709; DOI: 10.1212/WNL.0b013e318293e2fe

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
178

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective: We sought to determine the rate of urine toxicology screening, differences in testing, and outcomes among patients with stroke and TIA presenting to a tertiary care emergency department.

Methods: In this retrospective cohort study, patients admitted with stroke or TIA to a single tertiary care stroke center between June 2005 and January 2007 were identified through a stroke database. Factors that predicted urine toxicology screening of patients and a positive test, and discharge outcomes of patients based on toxicology result were analyzed. Stroke severity, treatment with tissue plasminogen activator, discharge status, and stroke etiology were compared between toxicology positive and negative patients.

Results: A total of 1,024 patients were identified: 704 with ischemic stroke, 133 with intracerebral hemorrhage, and 205 with TIA. Urine toxicology screening was performed in 420 patients (40%); 11% of these studies were positive for cocaine (19% younger than 50 years and 9% 50 years or older). Factors that significantly predicted the performance of a urine toxicology screen were younger age (<50 years) and black race (<0.001). Positive toxicology screens occurred in a broad range of patients. There were no significant differences in admission NIH Stroke Scale score, stroke etiology, and discharge status between toxicology-positive and -negative patients.

Conclusions: In this study, patients with stroke and TIA who were young and black were more likely to have urine toxicology screening. Eleven percent of all tested patients (and 9% of patients 50 years or older) were positive for cocaine. To avoid disparities, we suggest that all stroke and TIA patients be tested.

GLOSSARY

MDMA=
3,4-methylenedioxy-N-methylamphetamin;
NIHSS=
NIH Stroke Scale;
TOAST=
Trial of Org 10172 in Acute Stroke Treatment;
tPA=
tissue plasminogen activator

Footnotes

  • The study was performed at Henry Ford Hospital at the time that all authors worked there.

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 1632

  • Received September 9, 2012.
  • Accepted in final form January 28, 2013.
  • © 2013 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Disputes & Debates: Rapid online correspondence

No comments have been published for this article.
Comment

REQUIREMENTS

If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • GLOSSARY
    • METHODS
    • RESULTS
    • DISCUSSION
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
Advertisement

Related Articles

  • Profiling patients

Topics Discussed

  • All Health Services Research
  • All Cerebrovascular disease/Stroke
  • Cocaine
  • Other toxicology

Alert Me

  • Alert me when eletters are published
Neurology: 99 (1)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • Neurology: Education
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2022 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise