Needles and the damage done: Reasons for admission and financial costs associated with injecting drug use in a Central London Teaching Hospital
Needles and the damage done: Reasons for admission and financial costs associated with injecting drug use in a Central London Teaching Hospital
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DOI：
10.1016/j.jinf.2012.10.004
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发表时间：
2013-01-01
影响因子：
28.2
通讯作者：
Doherty, Justin F.
中科院分区：
文献类型：
--
作者：
Marks, Michael;Pollock, Emily;Doherty, Justin F.
目的：了解静脉吸毒者住院的临床原因。以确定他们在护理过程中出现行为问题的频率，并估计注射吸毒对卫生服务的财务影响。方法：在伦敦大学学院医院进行回顾性队列研究。临床、实验室和财务数据从病例记录和电子记录中提取。结果：在2005-2009年间，124名注射吸毒者需要191次入院。皮肤和软组织感染(58%)和肺炎(18%)是最常见的入院原因。入院时的菌血症通常不伴有炎症反应。接触艾滋病毒(4%)、乙肝(49%)和丙型肝炎(84%)是很常见的。入院期间药物滥用频繁(16%)。NHS治疗吸毒者软组织感染的费用每年约为7700万英镑。中位随访40个月后，有10名患者(8%)死亡。所有死亡均可归因于药物使用。结论：细菌和病毒感染是注射吸毒者接受二级护理的显著死亡率和发病率的主要原因。NHS的财政负担是巨大的。(C)2012年英国感染协会。爱思唯尔有限公司出版。保留所有权利。
Objectives: To establish the clinical reasons for inpatient admissions among injecting drug users. To determine the frequency of behavioural issues during their care and to estimate the financial implications of injecting drug use to the health service.Methods: Retrospective cohort study at University College London Hospital. Clinical, laboratory and financial data were extracted from case notes and electronic records. The cost of each admission was compared to the income received for the period of care.Results: 124 injecting drug users required 191 admissions between 2005 and 2009. Skin and soft tissue infections (58%) and pneumonia (18%) were the commonest reasons for admission. Bacteraemia at admission was often not accompanied by an inflammatory response. Exposure to HIV (4%), hepatitis B (49%) and C (84%) was common. Drug misuse (16%) during admission was frequent. The cost to the NHS of treating soft tissue infections in drug users was approximately 77 pound million per annum. After a median follow-up of 40 months, 10 patients (8%) had died. All deaths were attributable to drug use.Conclusions: Bacterial and viral infections are largely responsible for the significant mortality and morbidity of injecting drug users presenting to secondary care. The financial burden to the NHS is substantial. (C) 2012 The British Infection Association. Published by Elsevier Ltd. All rights reserved.