Skip to main content
Erschienen in: Journal of General Internal Medicine 3/2007

01.03.2007 | Populations at Risk

Predictors of Hospitalization for Injection Drug Users Seeking Care for Soft Tissue Infections

verfasst von: Traci A. Takahashi, MD, MPH, Amy Baernstein, MD, MPH, Ingrid Binswanger, MD, MS, Katharine Bradley, MD, MPH, Joseph O. Merrill, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 3/2007

Einloggen, um Zugang zu erhalten

Abstract

BACKGROUND

Soft tissue infections (STIs) from injection drug use are a common cause of Emergency Department visits, hospitalizations, and operating room procedures, yet little is known about factors that may predict the need for these costly medical services.

OBJECTIVE

To describe a cohort of injection drug users seeking Emergency Department care for STIs and to identify risk factors associated with hospitalization. We hypothesized that participants who delayed seeking care would be hospitalized more often than those who did not.

DESIGN

Cohort study using in-person structured interviews and medical record review. Logistic regression assessed the association between hospital admission and delay in seeking care as well as other demographic, clinical, and psychosocial factors.

PARTICIPANTS

Injection drug users who sought Emergency Department care for STIs from May 2001 to March 2002.

RESULTS

Of the 136 participants, 55 (40%) were admitted to the hospital. Delay in seeking care was not associated with hospital admission. Participants admitted for their infection were significantly more likely to be living in a shelter (P = .01) and to report being hospitalized 2 or more times in the past year (P < .01).

CONCLUSIONS

We identified a subpopulation of injection drug users, mostly living in shelters, who were hospitalized frequently in the past year and who were more likely to be hospitalized for their current infections compared to others. As members of this subpopulation can be easily identified and located, they may benefit from interventions to reduce the health care utilization resulting from these infections.
Literatur
1.
Zurück zum Zitat Binswanger IA, Kral AH, Bluthenthal RN, Rybold DJ, Edlin BR. High prevalence of abscesses and cellulitis among community-recruited injection drug users in San Francisco. Clin Infect Dis. 2000;30(3):579–81.PubMedCrossRef Binswanger IA, Kral AH, Bluthenthal RN, Rybold DJ, Edlin BR. High prevalence of abscesses and cellulitis among community-recruited injection drug users in San Francisco. Clin Infect Dis. 2000;30(3):579–81.PubMedCrossRef
2.
Zurück zum Zitat CDC. Unexplained illness and death among injecting-drug users—Glasgow, Scotland; Dublin, Ireland; and England, April–June 2000. MMWR. 2000;49(22):489–92. CDC. Unexplained illness and death among injecting-drug users—Glasgow, Scotland; Dublin, Ireland; and England, April–June 2000. MMWR. 2000;49(22):489–92.
3.
Zurück zum Zitat Lonergan S, Rodriguez RM, Schaulis M, Navaran P. A case series of patients with black tar heroin-associated necrotizing fasciitis. J Emerg Med. 2004;26(1):47–50.PubMedCrossRef Lonergan S, Rodriguez RM, Schaulis M, Navaran P. A case series of patients with black tar heroin-associated necrotizing fasciitis. J Emerg Med. 2004;26(1):47–50.PubMedCrossRef
4.
Zurück zum Zitat Charlebois ED, Bangsberg DR, Moss NJ, et al. Population-based community prevalence of methicillin-resistant Staphylococcus aureus in the urban poor of San Francisco [see comment]. Clin Infect Dis. 2002;34(4):425–33.PubMedCrossRef Charlebois ED, Bangsberg DR, Moss NJ, et al. Population-based community prevalence of methicillin-resistant Staphylococcus aureus in the urban poor of San Francisco [see comment]. Clin Infect Dis. 2002;34(4):425–33.PubMedCrossRef
5.
Zurück zum Zitat Frazee BW, Lynn J, Charlebois ED, Lambert L, Lowery D, Perdreau-Remington F. High prevalence of methicillin-resistant Staphylococcus aureus in Emergency Department skin and soft tissue infections. Ann Emerg Med. 2005;45(3):311–20.PubMedCrossRef Frazee BW, Lynn J, Charlebois ED, Lambert L, Lowery D, Perdreau-Remington F. High prevalence of methicillin-resistant Staphylococcus aureus in Emergency Department skin and soft tissue infections. Ann Emerg Med. 2005;45(3):311–20.PubMedCrossRef
6.
Zurück zum Zitat Young DM, Harris HW, Charlebois ED, et al. An epidemic of methicillin-resistant Staphylococcus aureus soft tissue infections among medically underserved patients. Arch Surg. 2004;139(9):947–51; discussion 951–3.PubMedCrossRef Young DM, Harris HW, Charlebois ED, et al. An epidemic of methicillin-resistant Staphylococcus aureus soft tissue infections among medically underserved patients. Arch Surg. 2004;139(9):947–51; discussion 951–3.PubMedCrossRef
7.
Zurück zum Zitat Morgan G, Krishnadasan A, Gorwitz R, et al. Methicillin-resistant S. aureus infections among patients in the Emergency Department. N Engl J Med. 2006;355(7):666–74.CrossRef Morgan G, Krishnadasan A, Gorwitz R, et al. Methicillin-resistant S. aureus infections among patients in the Emergency Department. N Engl J Med. 2006;355(7):666–74.CrossRef
8.
Zurück zum Zitat CDC. Soft tissue infections among injection drug users—San Francisco, California, 1996–2000. MMWR. 2001;50(19):381–4. CDC. Soft tissue infections among injection drug users—San Francisco, California, 1996–2000. MMWR. 2001;50(19):381–4.
9.
Zurück zum Zitat Wallace JR, Lucas CE, Ledgerwood AM. Social, economic, and surgical anatomy of a drug-related abscess. Am Surgeon. 1986;52(7):398–401.PubMed Wallace JR, Lucas CE, Ledgerwood AM. Social, economic, and surgical anatomy of a drug-related abscess. Am Surgeon. 1986;52(7):398–401.PubMed
10.
Zurück zum Zitat Palepu A, Tyndall MW, Leon H, et al. Hospital utilization and costs in a cohort of injection drug users. CMAJ. 2001;165(4):415–20.PubMed Palepu A, Tyndall MW, Leon H, et al. Hospital utilization and costs in a cohort of injection drug users. CMAJ. 2001;165(4):415–20.PubMed
11.
Zurück zum Zitat Takahashi TA, Merrill JO, Boyko EJ, Bradley KA. Type and location of injection drug use-related soft tissue infections predict hospitalization. J Urban Health. 2003;80(1):127–36.PubMedCrossRef Takahashi TA, Merrill JO, Boyko EJ, Bradley KA. Type and location of injection drug use-related soft tissue infections predict hospitalization. J Urban Health. 2003;80(1):127–36.PubMedCrossRef
12.
Zurück zum Zitat Sacks JA, Drake RE, Williams VF, Banks SM, Herrell JM. Utility of the time-line follow-back to assess substance use among homeless adults. J Nerv Ment Dis. 2003;191(3):145–53.PubMedCrossRef Sacks JA, Drake RE, Williams VF, Banks SM, Herrell JM. Utility of the time-line follow-back to assess substance use among homeless adults. J Nerv Ment Dis. 2003;191(3):145–53.PubMedCrossRef
13.
Zurück zum Zitat Hagan H, McGough JP, Thiede H, Hopkins S, Duchin J, Alexander ER. Reduced injection frequency and increased entry and retention in drug treatment associated with needle-exchange participation in Seattle drug injectors. J Subst Abuse Treat. 2000;19(3):247–52.PubMedCrossRef Hagan H, McGough JP, Thiede H, Hopkins S, Duchin J, Alexander ER. Reduced injection frequency and increased entry and retention in drug treatment associated with needle-exchange participation in Seattle drug injectors. J Subst Abuse Treat. 2000;19(3):247–52.PubMedCrossRef
14.
Zurück zum Zitat Kral AH, Bluthenthal RN, Lorvick J, Gee L, Bacchetti P, Edlin BR. Sexual transmission of HIV-1 among injection drug users in San Francisco, USA: risk-factor analysis. Lancet. 2001;357(9266):1397–401.PubMedCrossRef Kral AH, Bluthenthal RN, Lorvick J, Gee L, Bacchetti P, Edlin BR. Sexual transmission of HIV-1 among injection drug users in San Francisco, USA: risk-factor analysis. Lancet. 2001;357(9266):1397–401.PubMedCrossRef
15.
Zurück zum Zitat Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA, for the Ambulatory Care Quality Improvement Project. The AUDIT Alcohol Consumption Questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med. 1998;158(16):1789–95.PubMedCrossRef Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA, for the Ambulatory Care Quality Improvement Project. The AUDIT Alcohol Consumption Questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med. 1998;158(16):1789–95.PubMedCrossRef
16.
Zurück zum Zitat Dawson DA, Grant BF, Stinson FS, Zhou Y. Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the US general population. Alcohol Clin Exp Res. 2005;29(5):844–54.PubMedCrossRef Dawson DA, Grant BF, Stinson FS, Zhou Y. Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the US general population. Alcohol Clin Exp Res. 2005;29(5):844–54.PubMedCrossRef
17.
Zurück zum Zitat McLellan AT, Kushner H, Metzger D, et al. The fifth edition of the addiction severity index. J Subst Abuse Treat. 1992;9(3):199–213.PubMedCrossRef McLellan AT, Kushner H, Metzger D, et al. The fifth edition of the addiction severity index. J Subst Abuse Treat. 1992;9(3):199–213.PubMedCrossRef
18.
Zurück zum Zitat Murphy EL, DeVita D, Liu H, et al. Risk factors for skin and soft-tissue abscesses among injection drug users: a case-control study. Clin Infect Dis. 2001;33(1):35–40.PubMedCrossRef Murphy EL, DeVita D, Liu H, et al. Risk factors for skin and soft-tissue abscesses among injection drug users: a case-control study. Clin Infect Dis. 2001;33(1):35–40.PubMedCrossRef
19.
Zurück zum Zitat Weber JT. Community-associated methicillin-resistant Staphylococcus aureus. Clin Infect Dis. 2005;41(S4):S269–72.PubMedCrossRef Weber JT. Community-associated methicillin-resistant Staphylococcus aureus. Clin Infect Dis. 2005;41(S4):S269–72.PubMedCrossRef
20.
Zurück zum Zitat Baillargeon J, Kelley MF, Leach CT, Baillargeon G, Pollock BH. Methicillin-resistant Staphylococcus aureus infection in the Texas prison system. Clin Infect Dis. 2004;38(9):e92–5.PubMedCrossRef Baillargeon J, Kelley MF, Leach CT, Baillargeon G, Pollock BH. Methicillin-resistant Staphylococcus aureus infection in the Texas prison system. Clin Infect Dis. 2004;38(9):e92–5.PubMedCrossRef
Metadaten
Titel
Predictors of Hospitalization for Injection Drug Users Seeking Care for Soft Tissue Infections
verfasst von
Traci A. Takahashi, MD, MPH
Amy Baernstein, MD, MPH
Ingrid Binswanger, MD, MS
Katharine Bradley, MD, MPH
Joseph O. Merrill, MD, MPH
Publikationsdatum
01.03.2007
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 3/2007
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-006-0079-y

Weitere Artikel der Ausgabe 3/2007

Journal of General Internal Medicine 3/2007 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Reizdarmsyndrom: Diäten wirksamer als Medikamente

29.04.2024 Reizdarmsyndrom Nachrichten

Bei Reizdarmsyndrom scheinen Diäten, wie etwa die FODMAP-arme oder die kohlenhydratreduzierte Ernährung, effektiver als eine medikamentöse Therapie zu sein. Das hat eine Studie aus Schweden ergeben, die die drei Therapieoptionen im direkten Vergleich analysierte.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.