Olubamwo Olubunmi, Onyeka Ifeoma N, Aregbesola Alex, Ronkainen Kimmo, Tiihonen Jari, Föhr Jaana, Kauhanen Jussi
Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland.
SAGE Open Med. 2017 Dec 15;5:2050312117740987. doi: 10.1177/2050312117740987. eCollection 2017.
This study examined the association between the route of drug administration and being hospitalized for infective endocarditis among 4817 treatment-seeking illicit drug users in Finland.
Cox regression models were used to examine the association between the route of drug administration and infective endocarditis hospitalization, adjusted for age, gender, and homelessness. Cases of infective endocarditis as a primary/main diagnosis were tracked using the 10th version of the International Classification of Disease code I33.
In all, 47 persons had a primary diagnosis of infective endocarditis. These 47 persons contributed a total of 95 hospitalizations and their total length of hospital stay was 1393 days. There was a statistically significant difference in hospitalizations between injectors and non-injectors (Log-Rank test p = 0.018). Univariate Cox model showed that injectors had higher hazard or risk for infective endocarditis hospitalization compared to non-injectors (hazard ratio: 2.04, 95% confidence interval: 1.12-3.73, p = 0.020). After adjusting for age, gender, and homelessness in the multivariate model, the elevated hazard among injectors compared to non-injectors remained statistically significant with adjusted hazard ratio of 2.12 (95% confidence interval: 1.11-4.07, p = 0.024).
The study findings suggested a need to boost harm reduction measures targeting high-risk injecting and other health behaviors among injecting drug users in order to reduce their hospitalizations for infective endocarditis.
本研究调查了芬兰4817名寻求治疗的非法药物使用者中，药物给药途径与感染性心内膜炎住院之间的关联。
采用Cox回归模型来研究药物给药途径与感染性心内膜炎住院之间的关联，并对年龄、性别和无家可归状况进行了调整。使用国际疾病分类第10版代码I33追踪以感染性心内膜炎作为主要诊断的病例。
总共有47人被初步诊断为感染性心内膜炎。这47人总共住院95次，住院总时长为1393天。注射吸毒者和非注射吸毒者之间的住院情况存在统计学上的显著差异（对数秩检验p = 0.018）。单变量Cox模型显示，与非注射吸毒者相比，注射吸毒者因感染性心内膜炎住院的风险更高（风险比：2.04，95%置信区间：1.12 - 3.73，p = 0.020）。在多变量模型中对年龄、性别和无家可归状况进行调整后，与非注射吸毒者相比，注射吸毒者的风险升高在统计学上仍具有显著性，调整后的风险比为2.12（95%置信区间：1.11 - 4.07，p = 0.024）。
研究结果表明，有必要加强针对注射吸毒者的高风险注射及其他健康行为的减少伤害措施，以降低他们因感染性心内膜炎住院的次数。
