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Using Population Based Hospitalization Data to Monitor Increases in Conditions Causing Morbidity Among Persons Who Inject Drugs

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Abstract

Epidemics of opioid use and injection drug use (IDU) are associated with an increase in HIV and viral hepatitis infections and overdose deaths in the United States. Persons who inject drugs (PWID) are also at risk for serious infections caused by skin organisms introduced via IDU. We examined National Inpatient Sample hospital discharge data to determine trends in three serious infectious disease-associated conditions that primarily affect PWID in addition to HIV and viral hepatitis: infective endocarditis (IE), central nervous system (CNS) abscesses, and osteomyelitis. We found an increase in the number of primary hospitalization discharge diagnoses for IE among persons aged ≤39 years from 2009 to 2013. Hospitalization rates for these diagnoses also increased over this study period for person with secondary diagnoses of hepatitis B, C, or D viruses and substance-related disorders for IE, CNS abscess and osteomyelitis. Policies that improve access to sterile injection equipment, improve education regarding IDU, and treatment for substance use disorder may help to reduce the impact of serious and often fatal infectious diseases among PWID.

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The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of Viral Hepatitis, Centers for Disease Control and Prevention, Mailstop G-37, 1600 Clifton Rd NE, Atlanta, GA, 30329, USA

    Melissa G. Collier, Mona Doshani & Alice Asher

Authors
  1. Melissa G. Collier
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  2. Mona Doshani
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  3. Alice Asher
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Corresponding author

Correspondence to Melissa G. Collier.

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Appendix

Appendix

ICD9-CM, Procedure, and Clinical Classifications Software codes used to define primary and secondary diagnoses.

ICD9-CM codes.

Primary diagnosis

ICD9-CM or procedure codes

Intracranial and intraspinal abscess

324.0, 324.1, 324.9

Osteomyelitis

730.00, 730.01, 730.02, 730.03, 730.04, 730.05, 730.06, 730.07, 730.08, 730.09, 730.20, 730.21, 730.22, 730.23, 730.24, 730.25, 730.26, 730.27, 730.28, 730.29

Endocarditis

421.0, 421.1, 421.9

Viral Hepatitis B, C, and D

070.2, 070.21, 070.22, 070.23, 070.3, 070.31, 070.32, 070.33, 070.4, 070.41, 070.42, 070.44, 070.49, 070.5, 070.51, 070.52, 070.54, 070.59, 070.6, 070.7, 070.71, 070.9

HIV

042.0, 042.1, 042.2, 042.9, 043.0, 043.1, 043.2, 043.3, 043.9, 044.0, 044.9, 079.53, 279.10, 279.19, 795.71, 795.8, V08

Substance abuse related disorders

292.0, 292.11, 292.12, 292.2, 292.81, 292.82, 292.83, 292.84, 292.85, 292.89, 292.9, 304.0, 304.1, 304.2, 304.3, 304.10, 304.11, 304.12, 304.13, 304.20, 304.21, 304.22, 304.23, 304.30, 304.31, 304.32, 304.33, 304.40, 304.41, 304.42, 304.43, 304.50, 304.51, 304.52, 304.53, 304.60, 304.61, 304.62, 304.63, 304.71, 304.72, 304.73, 304.80, 304.81, 304.82, 304.83, 304.90, 304.91, 304.92, 304.93, 305.20, 305.21, 305.22, 305.23, 305.30, 305.31, 305.32, 305.33, 305.40, 305.41, 305.42, 305.43, 305.50, 305.51, 305.52, 305.53, 305.60, 305.61, 305.62, 305.63, 305.70, 305.71, 305.72, 305.73, 305.80, 305.81, 305.82, 305.83, 305.90, 305.91, 305.92, 305.93, 648.30, 648.31, 648.32, 648.33, 648.34, 655.50, 655.51, 655.53, 760.72, 760.73, 760.75, 779.5, 965.0, 965.01

965.02, 965.09, V654.2

Alcohol abuse related disorders

291.0, 291.1, 291.2, 291.3, 291.4, 291.5, 291.8, 291.81, 291.82, 291.89, 291.9, 303.0, 303.01, 303.02, 303.03, 303.90, 303.91, 303.92, 303.93, 305.0, 305.01, 305.02, 305.03, 760.71, 980.0

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Collier, M.G., Doshani, M. & Asher, A. Using Population Based Hospitalization Data to Monitor Increases in Conditions Causing Morbidity Among Persons Who Inject Drugs. J Community Health 43, 598–603 (2018). https://doi.org/10.1007/s10900-017-0458-9

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