Takahashi Traci A, Baernstein Amy, Binswanger Ingrid, Bradley Katharine, Merrill Joseph O
VA Puget Sound Health Care System, Seattle, WA 98108, USA.
J Gen Intern Med. 2007 Mar;22(3):382-8. doi: 10.1007/s11606-006-0079-y.
Soft tissue infections (STIs) from injection drug use are a common cause of Emergency Department visits, hospitalizations, and operating room procedures, yet little is known about factors that may predict the need for these costly medical services.
To describe a cohort of injection drug users seeking Emergency Department care for STIs and to identify risk factors associated with hospitalization. We hypothesized that participants who delayed seeking care would be hospitalized more often than those who did not.
Cohort study using in-person structured interviews and medical record review. Logistic regression assessed the association between hospital admission and delay in seeking care as well as other demographic, clinical, and psychosocial factors.
Injection drug users who sought Emergency Department care for STIs from May 2001 to March 2002.
Of the 136 participants, 55 (40%) were admitted to the hospital. Delay in seeking care was not associated with hospital admission. Participants admitted for their infection were significantly more likely to be living in a shelter (P = .01) and to report being hospitalized 2 or more times in the past year (P < .01).
We identified a subpopulation of injection drug users, mostly living in shelters, who were hospitalized frequently in the past year and who were more likely to be hospitalized for their current infections compared to others. As members of this subpopulation can be easily identified and located, they may benefit from interventions to reduce the health care utilization resulting from these infections.
注射吸毒引发的软组织感染（STIs）是急诊就诊、住院治疗及手术室手术的常见原因，但对于可能预测这些昂贵医疗服务需求的因素，我们知之甚少。
描述一组因STIs到急诊科就诊的注射吸毒者队列，并确定与住院相关的危险因素。我们假设延迟就诊的参与者比未延迟就诊的参与者更常住院。
采用面对面结构化访谈和病历审查的队列研究。逻辑回归评估了住院与延迟就诊以及其他人口统计学、临床和社会心理因素之间的关联。
2001年5月至2002年3月期间因STIs到急诊科就诊的注射吸毒者。
136名参与者中，55人（40%）住院。延迟就诊与住院无关。因感染住院的参与者更有可能住在收容所（P = 0.01），且报告在过去一年住院2次或更多次（P < 0.01）。
我们确定了一组注射吸毒者亚群，他们大多住在收容所，在过去一年频繁住院，与其他人相比，他们因当前感染住院的可能性更大。由于该亚群成员易于识别和定位，他们可能会受益于旨在减少这些感染导致的医疗保健利用的干预措施。
