Trends in Drug Use–Associated Infective Endocarditis and Heart Valve Surgery, 2007 to 2017

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Abstract

Drug use-associated infective endocarditis (DUA-IE) is increasing as a result of the opioid epidemic. Infective endocarditis may require valve surgery, but surgical treatment of DUA-IE has invoked controversy, and the extent of its use is unknown.

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Increases in Acute Hepatitis C Virus Infection Related to a Growing Opioid Epidemic and Associated Injection Drug Use, United States, 2004 to 2014

Jon E Zibbell, Alice Asher, Rajiv C Patel … (2018)

To compare US trends in rates of injection drug use (IDU), specifically opioid injection, with national trends in the incidence of acute HCV infection to assess whether these events correlated over time.

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Increasing Infectious Endocarditis Admissions Among Young People Who Inject Drugs

Alysse Wurcel, Jordan E. Anderson, Kenneth K. H. Chui … (2016)

People who inject drugs (PWID) are at risk for infective endocarditis (IE). Hospitalization rates related to misuse of prescription opioids and heroin have increased in recent years, but there are no recent investigations into rates of hospitalizations from injection drug use-related IE (IDU-IE). Using the Health Care and Utilization Project National Inpatient Sample (HCUP-NIS) dataset, we found that the proportion of IE hospitalizations from IDU-IE increased from 7% to 12.1% between 2000 and 2013. Over this time period, we detected a significant increase in the percentages of IDU-IE hospitalizations among 15- to 34-year-olds (27.1%–42.0%; P < .001) and among whites (40.2%–68.9%; P < .001). Female gender was less common when examining all the IDU-IE (40.9%), but it was more common in the 15- to 34-year-old age group (53%). Our findings suggest that the demographics of inpatients hospitalized with IDU-IE are shifting to reflect younger PWID who are more likely to be white and female than previously reported. Future studies to investigate risk behaviors associated with IDU-IE and targeted harm reduction strategies are needed to avoid further increases in morbidity and mortality in this rapidly growing population of young PWID.

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Hospitalizations Related To Opioid Abuse/Dependence And Associated Serious Infections Increased Sharply, 2002-12.

Matthew Ronan, Shoshana Herzig (2016)

Serious infection is a recognized complication of intravenous drug abuse and a major cause of morbidity and mortality among intravenous drug users. Trends in rates of serious infection and the associated costs related to opioid abuse/dependence have not been previously investigated in the context of the US opioid use epidemic. Our study, using a nationally representative sample of US inpatient hospitalizations, showed that hospitalizations related to opioid abuse/dependence both with and without associated serious infection significantly increased from 2002 to 2012, respectively, from 301,707 to 520,275 and from 3,421 to 6,535. Additionally, inpatient charges for both types of hospitalizations almost quadrupled over the same time period, reaching almost $15 billion for hospitalizations related to opioid abuse/dependence and more than $700 million for those related to associated infection in 2012. Medicaid was the most common primary payer for both types of hospitalizations. Our results characterize the financial burden on the health care system related to opioid abuse/dependence and one of the more serious downstream complications of this epidemic: serious infection. These findings have important implications for the hospitals and government agencies that disproportionately shoulder these costs and for clinicians, researchers, and policy makers interested in estimating the potential impact of targeted public health interventions on a national level.

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Author and article information

Journal

Title: Annals of Internal Medicine

Abbreviated Title: Ann Intern Med

Publisher: American College of Physicians

ISSN (Print): 0003-4819

Publication date (Electronic): December 04 2018

Affiliations

[1 ]University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (A.J.S., D.L.R.)

[2 ]Centers for Disease Control and Prevention, Atlanta, Georgia (A.F.)

[3 ]Duke University School of Medicine, Durham, North Carolina (V.H.C.)

[4 ]Duke University School of Medicine, Duke University Medical Center, and Duke University, Durham, North Carolina (L.W.)

Article

DOI: 10.7326/M18-2124

PMC ID: 6548681

PubMed ID: 30508432

SO-VID: 045f63ea-b948-47f5-af70-7b7045305137

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Trends in Drug Use–Associated Infective Endocarditis and Heart Valve Surgery, 2007 to 2017 : A Study of Statewide Discharge Data

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Most cited references 30

Increases in Acute Hepatitis C Virus Infection Related to a Growing Opioid Epidemic and Associated Injection Drug Use, United States, 2004 to 2014

Increasing Infectious Endocarditis Admissions Among Young People Who Inject Drugs

Hospitalizations Related To Opioid Abuse/Dependence And Associated Serious Infections Increased Sharply, 2002-12.

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