NDLI: Clinical profile of injection drug users presenting to the ED.

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Clinical profile of injection drug users presenting to the ED.

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Clinical profile of injection drug users presenting to the ED.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kievlan, Daniel R. Gukasyan, Meri Gesch, Julie Rodriguez, Robert M.
Description	Country affiliation: Canada Author Affiliation: Kievlan DR ( Department of Emergency Medicine, The University of California San Francisco, San Francisco, CA.); Gukasyan M ( Department of Emergency Medicine, The University of California San Francisco, San Francisco, CA.); Gesch J ( Department of Emergency Medicine, The University of California San Francisco, San Francisco, CA.); Rodriguez RM ( Department of Emergency Medicine, The University of California San Francisco, San Francisco, CA. Electronic address: Robert.rodriguez@emergency.ucsf.edu.)
Abstract	BACKGROUND: Injection drug users (IDUs) commonly use the emergency department (ED) as their primary health care access point. OBJECTIVE: We sought to characterize infectious disease clinical presentations and laboratory results of IDUs admitted to the hospital from the ED and contrast them with those of non-IDUs. METHODS: We enrolled all admitted adult patients with infectious disease-related diagnoses at a county level 1 trauma center from June 2010 to January 2011 and used a structured chart abstraction tool to record patient characteristics and clinical outcomes. We compared clinical presenting features, laboratory data, and microbiological culture results of IDUs with concomitantly enrolled non-IDUs. RESULTS: Of 603 total participants, 189 were IDUs, and 414 were non-IDUs. Injection drug users had higher rates of skin and soft tissue infection admission but had similar hospital length of stay (7.5 vs 6.1 days) and mortality (2.1% vs 2.9%). Compared with non-IDUs, IDUs more commonly had hyponatremia, 38.1% vs 27.1% (mean difference, 11.4%; 95% confidence intervals [CIs], 3.4%-19.6%) and thrombocytopenia, 18.5% vs 11.0% (mean difference, 7.5%; 95% CI, 1.5%-14.2%) but less frequently had leukocytosis, 36.0% vs 52.7% (mean difference, 16.7%; 95% CI, 8.2%-24.8%). Injection drug users and non-IDUs had similar rates of positive ED-derived blood cultures, 16.5% vs 22.6% (mean difference, 6.1%; 95% CI, -13.3 to 1.7%). CONCLUSIONS: When admitted from the ED for infectious disease-related diagnoses, IDUs had similar rates of fever, higher rates of hyponatremia and thrombocytopenia, and lower rates of leukocytosis than non-IDUs. Although they had similar rates of bacteremia, only IDUs were positive for methicillin-resistant Staphylococcus aureus.
File Format	HTM / HTML
ISSN	07356757
Issue Number	5
Volume Number	33
e-ISSN	15328171
Journal	The American Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2015-05-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency Discipline Medicine Drug Users Infection Epidemiology Microbiology Substance Abuse, Intravenous Adult Bacteremia Emergency Service, Hospital Female Hospital Mortality Humans Hyponatremia Length Of Stay Statistics & Numerical Data Leukocytosis Male Middle Aged Prospective Studies Skin Diseases, Infectious Soft Tissue Infections Thrombocytopenia Journal Article Observational Study
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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