Tsai Halley, Lee Justin, Hedlin Haley, Zamanian Roham T, de Jesus Perez Vinicio A
Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA, USA.
Quantitative Sciences Unit, Stanford University, Stanford, CA, USA.
ERJ Open Res. 2019 Oct 15;5(4). doi: 10.1183/23120541.00017-2019. eCollection 2019 Oct.
Methamphetamine can have acute and long-term adverse health consequences. Our objective was to determine whether methamphetamine use is associated with more hospitalisation codes for asthma exacerbation, chronic obstructive pulmonary disease (COPD) exacerbation, pneumonia and acute respiratory failure (ARF).
The Health Care Utilization Project (HCUP) database includes retrospective inpatient discharge abstracts from 2005 through 2011 from the California state inpatient databases (SIDs). ICD-9 codes were used to identify hospitalisations for asthma exacerbation, COPD exacerbation, acute pneumonia, ARF and methamphetamine use from discharges with complete demographic data and ages 18 to 75 years. Adjusted rate ratios comparing methamphetamine users with nonusers were estimated separately for each pulmonary disease diagnosis by sex using negative binomial regression models.
We included 21 125 249 inpatient discharges from 2005 through 2011 in California in our analysis; 182 766 (0.87%) had methamphetamine use. The rate ratio comparing pneumonia in discharges with methamphetamine use those without were 1.40 (95% CI 1.18, 1.67) for women and 1.18 (95% CI 1.04, 1.35) for men; comparing ARF 1.77 (95% CI 1.59, 1.98) for women and 1.24 (95% CI 1.12, 1.37) for men; and comparing COPD exacerbation 1.40 (95% CI 1.18, 1.67) for women and 0.90 (95% CI 0.79, 1.02) for men.
A positive association was found when comparing inpatient hospital discharge diagnoses for methamphetamine use and those for pneumonia and ARF in both sexes. This association was not seen when comparing discharge diagnoses for methamphetamine and those for asthma exacerbation in both sexes or COPD exacerbation in men. While future investigation for is warranted, this finding may help to further characterise the pulmonary toxicity of methamphetamine.
甲基苯丙胺可产生急性和长期的不良健康后果。我们的目标是确定使用甲基苯丙胺是否与更多因哮喘加重、慢性阻塞性肺疾病(COPD)加重、肺炎和急性呼吸衰竭(ARF)而住院的编码相关。
医疗保健利用项目(HCUP)数据库包含2005年至2011年加利福尼亚州住院患者数据库(SID)中的回顾性住院出院摘要。国际疾病分类第九版(ICD - 9)编码用于识别年龄在18至75岁且人口统计学数据完整的出院患者中因哮喘加重、COPD加重、急性肺炎、ARF和使用甲基苯丙胺而导致的住院情况。通过使用负二项回归模型,按性别对每种肺部疾病诊断分别估计使用甲基苯丙胺者与未使用者的调整率比。
我们在分析中纳入了2005年至2011年加利福尼亚州的21125249例住院出院病例;其中182766例(0.87%)使用了甲基苯丙胺。使用甲基苯丙胺的出院病例与未使用者相比,女性肺炎的率比为1.40(95%可信区间1.18,1.67),男性为1.18(95%可信区间1.04,1.35);ARF女性为1.77(95%可信区间1.59,1.98),男性为1.24(95%可信区间1.12,1.37);COPD加重女性为1.40(95%可信区间1.18,1.67),男性为0.90(95%可信区间0.79,1.02)。
在比较甲基苯丙胺使用者和非使用者的住院出院诊断时,发现两性中甲基苯丙胺使用与肺炎和ARF之间存在正相关。在比较两性中甲基苯丙胺使用与哮喘加重的出院诊断或男性中甲基苯丙胺使用与COPD加重的出院诊断时,未发现这种相关性。虽然有必要进行进一步研究,但这一发现可能有助于进一步明确甲基苯丙胺的肺部毒性。