White Simon R, Bird Sheila M, Merrall Elizabeth L C, Hutchinson Sharon J
Medical Research Council Biostatistics Unit, Cambridge Institute of Public Health, Cambridge, United Kingdom.
Novartis Pharam BV, Novartis Vaccines & Diagnostics, Hullenbergweg 83-85, 1101 CL Amsterdam, Netherlands.
PLoS One. 2015 Nov 5;10(11):e0141073. doi: 10.1371/journal.pone.0141073. eCollection 2015.
We validate that the 28 days after hospital-discharge are high-risk for drugs-related death (DRD) among drug users in Scotland and investigate key risk-factors for DRDs soon after hospital-discharge. Using data from an anonymous linkage of hospitalisation and death records to the Scottish Drugs Misuse Database (SDMD), including over 98,000 individuals registered for drug treatment during 1 April 1996 to 31 March 2010 with 705,538 person-years, 173,107 hospital-stays, and 2,523 DRDs. Time-at-risk of DRD was categorised as: during hospitalization, within 28 days, 29-90 days, 91 days-1 year, >1 year since most recent hospital discharge versus 'never admitted'. Factors of interest were: having ever injected, misuse of alcohol, length of hospital-stay (0-1 versus 2+ days), and main discharge-diagnosis. We confirm SDMD clients' high DRD-rate soon after hospital-discharge in 2006-2010. DRD-rate in the 28 days after hospital-discharge did not vary by length of hospital-stay but was significantly higher for clients who had ever-injected versus otherwise. Three leading discharge-diagnoses accounted for only 150/290 DRDs in the 28 days after hospital-discharge, but ever-injectors for 222/290. Hospital-discharge remains a period of increased DRD-vulnerability in 2006-2010, as in 1996-2006, especially for those with a history of injecting.
我们证实，在苏格兰，吸毒者出院后的28天是药物相关死亡（DRD）的高危期，并调查出院后不久发生DRD的关键风险因素。利用住院和死亡记录与苏格兰药物滥用数据库（SDMD）匿名关联的数据，其中包括1996年4月1日至2010年3月31日期间登记接受药物治疗的98000多人，705538人年，173107次住院，以及2523例DRD。DRD的风险期分为：住院期间、出院后28天内、29 - 90天、91天至1年、自最近一次出院后超过1年与“从未住院”。感兴趣的因素包括：曾经注射过、酒精滥用、住院时间（0 - 1天与2天及以上）以及主要出院诊断。我们证实了2006 - 2010年SDMD客户出院后不久的高DRD率。出院后28天内的DRD率不因住院时间长短而有所不同，但曾经注射过的客户的DRD率明显高于未注射过的客户。在出院后28天内，三种主要的出院诊断仅占290例DRD中的150例，但曾经注射过的人占290例中的222例。与1996 - 2006年一样，2006 - 2010年出院后仍然是DRD易感性增加的时期，尤其是对于有注射史的人。
