Department of Cardiology, University of Iowa Health Care, Carver College of Medicine, Iowa City, Iowa, USA.
Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York, USA.
Int J Cardiol. 2021 May 15;331:158-163. doi: 10.1016/j.ijcard.2021.01.060. Epub 2021 Jan 31.
Heart failure (HF) hospitalizations remains a significant burden on the health care system. Stimulants including cocaine, amphetamine and its derivatives are amongst the most used illegal substances in the United States. The information regarding stimulant-related HF hospitalizations is scarce. We sought to evaluate the characteristics and trends of stimulant-related HF hospitalizations in the United States and their associated outcomes and resource utilization.
Using the National Inpatient Sample (NIS), we identified patients with a primary diagnosis of HF hospitalization. These hospitalizations were further divided into those with and without a concomitant diagnosis of stimulant (cocaine or amphetamine) dependence or abuse. Survey specific techniques were employed to compare trends in baseline characteristics, complications, procedures, outcomes and resource utilization between the two cohorts.
We identified 9,932,753 hospitalizations (weighted) with a primary diagnosis of heart failure, of those 138,438 (1.39%) had a diagnosis of active stimulant use. The proportion of stimulant-related HF hospitalization is on the rise (1.1% to 1.9%). Stimulant-related HF hospitalization was highest amongst age group 30-39 years and 7.9% of HF hospitalizations in this age group were due to stimulant use. The proportion of stimulant-related HF hospitalization for the White and Hispanic race has doubled from 2008 to 2017. Stimulant-related HF hospitalization is associated with increased incidence of in-hospital complications like cardiogenic shock, acute kidney injury and ventricular tachycardia. These patients have more than 7-fold higher discharge against medical advice.
Stimulant-related HF hospitalizations have been increasing. It is associate with significant morbidity burden and health care utilization.
心力衰竭（HF）住院仍然是医疗保健系统的重大负担。兴奋剂包括可卡因、安非他命及其衍生物，是美国使用最多的非法物质之一。关于兴奋剂相关 HF 住院的信息很少。我们试图评估美国兴奋剂相关 HF 住院的特征和趋势及其相关结局和资源利用情况。
使用国家住院患者样本（NIS），我们确定了有心力衰竭住院治疗主要诊断的患者。这些住院治疗进一步分为伴有或不伴有兴奋剂（可卡因或安非他命）依赖或滥用合并诊断的住院治疗。采用特定于调查的技术来比较两个队列的基线特征、并发症、程序、结局和资源利用方面的趋势。
我们确定了 9932753 例（加权）有心力衰竭主要诊断的住院治疗，其中 138438 例（1.39%）有活动性兴奋剂使用诊断。兴奋剂相关 HF 住院的比例呈上升趋势（从 1.1%上升到 1.9%）。在 30-39 岁年龄组中，兴奋剂相关 HF 住院的比例最高，该年龄组中有 7.9%的 HF 住院是由于兴奋剂使用。从 2008 年到 2017 年，白人和西班牙裔兴奋剂相关 HF 住院的比例翻了一番。兴奋剂相关 HF 住院与院内并发症（如心源性休克、急性肾损伤和室性心动过速）的发生率增加有关。这些患者不遵医嘱出院的比例高出 7 倍以上。
兴奋剂相关 HF 住院的数量一直在增加。它与显著的发病率负担和医疗保健利用有关。
