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Endogenous endophthalmitis in patients with intravenous opioid use: demographics and associated comorbidities

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Abstract

Purpose

To identify risk factors for endogenous endophthalmitis (EE) in hospitalized adults, under 65 years of age, with a history of intravenous opioid use and non-ocular infection.

Methods

The National Inpatient Sample Database was used to identify cases of EE with a recent history of intravenous opioid use disorder with associated non-ocular infection. Systemic and ocular comorbidities were identified using codes from the International Classification of Diseases, Ninth Revision (ICD-9). Descriptive and regression analyses were performed to evaluate the risk factors for EE using IBM SPSS 23.

Results

Of the 605,859 inpatients, 21–65 years age, who had a history of recent opioid-IVDU and an associated IVDU-associated systemic infection, 363 (0.1%) had EE. Systemic comorbidities such as diabetes mellitus, mitral valve disease, aortic valve disease, history of cardiac valve transplantation, chronic kidney disease/renal failure, cirrhosis, active or previous radiation therapy, and history of solid organ transplantation were significantly more prevalent in patients with EE. A significantly increased risk of EE in intravenous opioid users was noted if they were of male gender (OR = 1.84), Asian/Pacific Islander ethnicity (OR = 4.41), had history of cirrhosis (OR = 2.33), active or history of radiation therapy (OR = 14.74), history of solid organ transplantation (OR = 5.91), candidemia (OR = 15.22), and infectious endocarditis (OR = 4.83). Conversely, concurrent alcohol use disorder (OR = 0.35) decreased the risk of EE.

Conclusion

Various demographic variables and systemic comorbidities increased the risk of developing EE in inpatients with a history of intravenous opioid use with associated non-ocular infection.

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Availability of data and material

The National Inpatient Sample Database is available for purchase from the Healthcare Cost and Utilization Project through its website.

Code availability

Programming code for this project was custom made.

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Funding

There were no sources of funding for this study.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Doctors Office Center, 90 Bergen Street, Suite 6100, Newark, NJ, 07103, USA

    Aditya Uppuluri, Marco A. Zarbin & Neelakshi Bhagat

Authors
  1. Aditya Uppuluri
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  2. Marco A. Zarbin
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  3. Neelakshi Bhagat
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Contributions

AU Conceptualization, Methodology, Software, Formal Analysis, Data Curation, Writing—Original Draft, Writing—Review and Editing. MAZ Formal Analysis, Writing—Review and Editing. NB Conceptualization, Methodology, Software, Formal Analysis, Data Curation, Writing—Original Draft, Writing—Review and Editing, Supervision, Project Administration.

Corresponding author

Correspondence to Neelakshi Bhagat.

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Conflict of interest

Aditya Uppuluri has no financial disclosures. Marco A. Zarbin is a consultant for Genentech/Roche, Novartis Pharma AG, Frequency Therapeutics, Iveric Bio, Ophthotech, and Healios KK. He is a stockholder for Frequency Therapeutics, Iveric Bio, and NVasc. He is a speaker for Iridex. He is Co-Founder of NVasc. Neelakshi Bhagat has no financial disclosures.

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Uppuluri, A., Zarbin, M.A. & Bhagat, N. Endogenous endophthalmitis in patients with intravenous opioid use: demographics and associated comorbidities. Int Ophthalmol 41, 1513–1520 (2021). https://doi.org/10.1007/s10792-021-01709-0

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  • DOI: https://doi.org/10.1007/s10792-021-01709-0

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