Levy Sera, Bassler John, Gagnon Kelly, Prados Myles, Jeziorski Madison, McCleskey Brandi, Crockett Kaylee, Li Li, Bradford Davis, Cropsey Karen, Eaton Ellen
Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, UAB, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Open Forum Infect Dis. 2022 Dec 30;10(1):ofac708. doi: 10.1093/ofid/ofac708. eCollection 2023 Jan.
Increasingly, injection opioid use and opioid use disorder (OUD) are complicated by methamphetamine use, but the impact of stimulant use on the care of people who inject drugs (PWID) with serious injection-related infections (SIRIs) is unknown. The objective of this study was to explore hospital outcomes and postdischarge trends for a cohort of hospitalized PWID to identify opportunities for intervention.
We queried the electronic medical record for patients hospitalized at the University of Alabama at Birmingham with injection drug use-related infections between 1/11/2016 and 4/24/2021. Patients were categorized as having OUD only (OUD), OUD plus methamphetamine use (OUD/meth), or injection of other substance(s) (other). We utilized statistical analyses to assess group differences across hospital outcomes and postdischarge trends. We determined the OUD continuum of care for those with OUD, with and without methamphetamine use.
A total of 370 patients met inclusion criteria-many with readmissions (98%) and high mortality (8%). The majority were White, male, and uninsured, with a median age of 38. One in 4 resided outside of a metropolitan area. There were significant differences according to substance use in terms of sociodemographics and hospital outcomes: patients with OUD/meth were more likely to leave via patient-directed discharge, but those with OUD only had the greatest mortality. Comorbid methamphetamine use did not significantly impact the OUD care continuum.
The current drug crisis in AL will require targeted interventions to engage a young, uninsured population with SIRI in evidence-based addiction and infection services.
注射用阿片类药物的使用及阿片类药物使用障碍（OUD）越来越多地因甲基苯丙胺的使用而变得复杂，但兴奋剂的使用对患有严重注射相关感染（SIRI）的注射吸毒者（PWID）护理的影响尚不清楚。本研究的目的是探讨一组住院PWID的医院结局及出院后趋势，以确定干预机会。
我们查询了2016年1月11日至2021年4月24日期间在阿拉巴马大学伯明翰分校因注射吸毒相关感染而住院的患者的电子病历。患者被分类为仅患有OUD（OUD）、OUD加甲基苯丙胺使用（OUD/甲基苯丙胺）或注射其他物质（其他）。我们利用统计分析来评估不同组在医院结局和出院后趋势方面的差异。我们确定了有或没有甲基苯丙胺使用的OUD患者的连续护理情况。
共有370名患者符合纳入标准，其中许多人再次入院（98%）且死亡率高（8%）。大多数患者为白人、男性且未参保，中位年龄为38岁。四分之一的患者居住在大都市地区以外。在社会人口统计学和医院结局方面，根据物质使用情况存在显著差异：OUD/甲基苯丙胺患者更有可能通过患者自主出院离开医院，但仅患有OUD的患者死亡率最高。甲基苯丙胺合并使用并未对OUD护理连续性产生显著影响。
阿拉巴马州当前的毒品危机将需要有针对性的干预措施，以使患有SIRI的年轻、未参保人群参与到基于证据的成瘾和感染服务中。
