Supplementary Material for: Prior Cannabis Use Is Associated with Outcome after Intracerebral Hemorrhage

<b><i>Objective:</i></b> Recent evidence suggests that a potential harmful relationship exists between cannabis use and ischemic stroke. The purpose of this study was to determine the implications of cannabis use in intracerebral hemorrhage (ICH) patients. <b><i>Methods:</i></b> An analysis of an international, multicenter, observational database of consecutive patients with spontaneous ICH was conducted. We extracted the following characteristics on presentation: demographics, risk factors, antiplatelet or anticoagulant use, Glasgow Coma Scale, ICH score, neuroimaging parameters, and urine toxicology screen (UTS) results. Modified Rankin Scale (mRS) score was utilized for determination of outcome at discharge. Adjusted logistic ordinal regression was used as shift analysis to assess the impact of cannabis use on mRS score at discharge. The adjusted common OR measured the likelihood that cannabis use would lead to lower mRS scores. <b><i>Results:</i></b> Within a cohort of 725 spontaneous ICH patients, UTS was positive for cannabinoids in 8.6%. Cannabinoids-positive (CB⁺) patients were more frequently Caucasian (p &lt; 0.001), younger (p &lt; 0.001), and had lower median ICH scores on admission (p = 0.017) than those who were cannabinoids-negative. CB⁺ patients also showed a shift toward better outcome in the distribution of mRS categories, with an adjusted common OR of 0.544 (95% CI 0.330-0.895, p = 0.017). <b><i>Conclusion:</i></b> In this multinational cohort, cannabis use was discovered in nearly 10% of patients with spontaneous ICH. Although there was no relationship between cannabis use and specific ICH characteristics, CB⁺ patients had milder ICH presentation and less disability at discharge.

<b><i>研究目的：</i></b> 现有研究证据表明，大麻使用与缺血性脑卒中之间可能存在潜在的有害关联。本研究旨在明确大麻使用对脑出血（intracerebral hemorrhage, ICH）患者的临床影响。<b><i>研究方法：</i></b> 本研究对一项纳入连续自发性脑出血患者的国际多中心观察性数据库进行了分析。我们提取了患者就诊时的以下临床特征：人口学资料、危险因素、抗血小板或抗凝药物使用情况、格拉斯哥昏迷量表（Glasgow Coma Scale）评分、ICH评分、神经影像学参数以及尿液毒理学筛查（urine toxicology screen, UTS）结果。以改良Rankin量表（Modified Rankin Scale, mRS）评分评估患者出院时的预后结局。采用校正有序logistic回归进行位移分析，以评估大麻使用对患者出院时mRS评分的影响；校正后的通用比值比（common OR）用于衡量大麻使用可使患者mRS评分降低的概率。<b><i>研究结果：</i></b> 在725名自发性ICH患者组成的研究队列中，8.6%的患者尿液毒理学筛查结果呈大麻素阳性（CB⁺）。与大麻素阴性（CB⁻）患者相比，CB⁺患者更常为白人（p < 0.001）、年龄更小（p < 0.001），且入院时ICH评分中位数更低（p = 0.017）。此外，CB⁺患者的mRS评分分布呈现出更佳预后的趋势，其校正后的通用比值比为0.544（95%置信区间：0.330~0.895，p = 0.017）。<b><i>研究结论：</i></b> 在这项跨国队列研究中，近10%的自发性ICH患者存在大麻使用史。尽管大麻使用与ICH的特定临床特征无明显关联，但CB⁺患者的ICH病情表现更轻微，且出院时的残疾程度更低。