Chotai N, Gallagher K, Kieffer W K M, Rogers B A, Ricketts D M
The Department of Trauma & Orthopaedics, Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, BN2 5BE, UK.
The Department of Trauma & Orthopaedics, Brighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, BN2 5BE, UK.
Surgeon. 2016 Feb;14(1):13-7. doi: 10.1016/j.surge.2014.08.003. Epub 2014 Sep 5.
Intravenous drug users (IVDU) often present to hospitals with complex co-morbidities, associated with prolonged in-patient admissions. The aim of this study was to compare a cohort of IVDU patients with soft tissue abscesses with non-IVDUs. We analysed the demographics, comorbidities, location of abscesses, multidisciplinary input and financial costs of managing both groups.
A retrospective cohort study was conducted between January 2010 and September 2013. Two age and sex matched cohorts were compared: IVDU and non-IVDU.
We identified 44 IVDU patients and 54 non-IVDU patients. The IVDU had higher rates of smoking (89% p < 0.001) and unemployment (73% p < 0.05). The most common comorbidities in the IVDU cohort were hepatitis C (17%) and HIV (14%), whereas diabetes mellitus (15%) and hypertension (11%) were the most common in the non-IVDUs (p < 0.01). The most common location for an abscess in non-IVDU patients was the hand, whereas IVDU patients had abscesses in their groin. Groin injecting led to a referral to multiple specialties. The median length of stay for the IVDU patients was 4 days and for non-IVDU patients 1 day (p < 0.01). The average cost of managing IVDU patients in our unit was £1280: for non- IVDU the cost was £530 (p < 0.001).
IVDU patients with soft tissue abscesses have higher rates of smoking, unemployment, infection with hepatitis C and HIV compared to a control group. We have suggested several recommendations to optimise the management of these patients including the implementation of an additional code to compensate for the complexity of their management.
静脉吸毒者（IVDU）常因复杂的合并症前往医院就诊，这与住院时间延长相关。本研究的目的是比较一组患有软组织脓肿的IVDU患者和非IVDU患者。我们分析了两组患者的人口统计学特征、合并症、脓肿位置、多学科投入及管理费用。
在2010年1月至2013年9月期间进行了一项回顾性队列研究。比较了两个年龄和性别匹配的队列：IVDU组和非IVDU组。
我们确定了44例IVDU患者和54例非IVDU患者。IVDU患者的吸烟率（89%，p<0.001）和失业率（73%，p<0.05）更高。IVDU队列中最常见的合并症是丙型肝炎（17%）和艾滋病毒（14%），而非IVDU患者中最常见的是糖尿病（15%）和高血压（11%）（p<0.01）。非IVDU患者脓肿最常见的部位是手部，而IVDU患者的脓肿在腹股沟。腹股沟注射导致转诊至多个专科。IVDU患者的中位住院时间为4天，非IVDU患者为1天（p<0.01）。我们科室管理IVDU患者的平均费用为1280英镑：非IVDU患者的费用为530英镑（p<0.001）。
与对照组相比，患有软组织脓肿的IVDU患者吸烟率、失业率、丙型肝炎和艾滋病毒感染率更高。我们提出了几项优化这些患者管理的建议，包括实施一个额外的编码以补偿其管理的复杂性。
