Predictors of Hospitalization for Injection Drug Users Seeking Care for Soft Tissue Infections
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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.
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.
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.
Injection drug users who sought Emergency Department care for STIs from May 2001 to March 2002.
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).
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.
KEY WORDSinjection drug use soft tissue infection cellulitis abscess substance abuse
This research was supported by the Health Services Research and Development Service, Department of Veterans Affairs; University of Washington Alcohol and Drug Abuse Institute, and the Robert Wood Johnson Foundation Clinical Scholars Program. Dr. Takahashi is a staff physician at the VA Puget Sound Health Care System and is currently supported by the National Institute on Drug Abuse (NIDA #RO3DA14518). Dr. Baernstein is a staff physician at Harborview Medical Center. Dr. Binswanger is an investigator at University of Colorado and was a VA Fellow in the Robert Wood Johnson Clinical Scholars Program at the University of Washington at the time this study was conducted. Dr. Bradley is an investigator at the VA Puget Sound Health Care System and is currently supported by the National Institute of Alcohol Abuse and Alcoholism (NIAAA #K23AA00313) and was a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar at the time this study was conducted. Dr. Merrill has received funding from Harborview Medical Center in support of this work.
Potential Financial Conflicts of Interest
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