Wurcel Alysse G, Anderson Jordan E, Chui Kenneth K H, Skinner Sally, Knox Tamsin A, Snydman David R, Stopka Thomas J
Department of Geographic Medicine and Infectious Diseases; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts.
Center for the Evaluation of Value and Risk in Health , Tufts Medical Center.
Open Forum Infect Dis. 2016 Jul 26;3(3):ofw157. doi: 10.1093/ofid/ofw157. eCollection 2016 Sep.
People who inject drugs (PWID) are at risk for infective endocarditis (IE). Hospitalization rates related to misuse of prescription opioids and heroin have increased in recent years, but there are no recent investigations into rates of hospitalizations from injection drug use-related IE (IDU-IE). Using the Health Care and Utilization Project National Inpatient Sample (HCUP-NIS) dataset, we found that the proportion of IE hospitalizations from IDU-IE increased from 7% to 12.1% between 2000 and 2013. Over this time period, we detected a significant increase in the percentages of IDU-IE hospitalizations among 15- to 34-year-olds (27.1%-42.0%; < .001) and among whites (40.2%-68.9%; < .001). Female gender was less common when examining all the IDU-IE (40.9%), but it was more common in the 15- to 34-year-old age group (53%). Our findings suggest that the demographics of inpatients hospitalized with IDU-IE are shifting to reflect younger PWID who are more likely to be white and female than previously reported. Future studies to investigate risk behaviors associated with IDU-IE and targeted harm reduction strategies are needed to avoid further increases in morbidity and mortality in this rapidly growing population of young PWID.
注射吸毒者（PWID）有感染性心内膜炎（IE）的风险。近年来，与处方阿片类药物和海洛因滥用相关的住院率有所上升，但近期尚无关于注射吸毒相关感染性心内膜炎（IDU-IE）住院率的调查。利用医疗保健和利用项目国家住院患者样本（HCUP-NIS）数据集，我们发现2000年至2013年间，IDU-IE导致的IE住院比例从7%增至12.1%。在此期间，我们发现15至34岁人群（从27.1%增至42.0%；P<0.001）和白人（从40.2%增至68.9%；P<0.001）中IDU-IE住院的百分比显著增加。在所有IDU-IE病例中，女性较少见（40.9%），但在15至34岁年龄组中更常见（53%）。我们的研究结果表明，因IDU-IE住院的患者人口统计学特征正在发生变化，以反映出比以往报告中更年轻、更可能为白人且女性的注射吸毒者。需要开展进一步研究以调查与IDU-IE相关的风险行为和有针对性的减少伤害策略，以避免在这一迅速增长的年轻注射吸毒者群体中发病率和死亡率进一步上升。
