Intravenous Drug Use‐Associated Endocarditis Leads to Increased Intracranial Hemorrhage and Neurological Comorbidities

BACKGROUND The United States is experiencing a rapidly increasing rate of opioid drug abuse. Intravenous use (IVDU)‐related endocarditis can lead to significant neurological complications with high morbidity and mortality. When patient care necessitates anticoagulation, the standards for radiographic screening risk intracranial hemorrhage are not clearly elucidated. METHODS We conducted retrospective cohort study involving patients treated infective at single institution from 2014 2018. Patients were grouped based in history IVDU their demographics clinical predictors analyzed. RESULTS A total 351 met inclusion criteria this study, whom 170 (48%) had IVDU‐associated endocarditis. was associated an increased prevalence (25.9% versus 13.9%; P =0.005), including intraparenchymal (12.4% 5.1%; =0.012), subarachnoid (17.6 4.4%; =0.001), cerebral microbleeds (14.1% 7.2%; =0.022). also incidence infectious aneurysm (10.6% 1.8%; =0.001) brain abscesses (4.7% 1.1%; =0.025). Multivariate analysis showed that presence septic emboli (odds ratio [OR], 18.47 [8.4–40.250]; (OR, 12.38 [3.24–47.28]; as predictive factors after presenting CONCLUSION epidemic has resultant neurovascular complications. hemorrhagic stroke more frequent neurodiagnostic imaging.