Long-term Outcomes of Injection Drug-related Infective Endocarditis Among People Who Inject Drugs
Long-term Outcomes of Injection Drug-related Infective Endocarditis Among People Who Inject Drugs
复制标题
DOI：
10.1097/adm.0000000000000572
复制
发表时间：
2020-07-01
影响因子：
5.5
通讯作者：
Weiss, Roger D.
中科院分区：
文献类型：
--
作者：
Suzuki, Joji;Johnson, Jennifer A.;Weiss, Roger D.
目的：注射毒品者感染性心内膜炎（IE）与高死亡率和心内膜炎反复发作有关。我们试图报告长期的临床结果，IE患者提供丁丙诺啡或美沙酮治疗阿片类药物使用障碍（OUD）在他们的初始hospitaladmission.Methods：个人与OUD住院2013年和2015年之间与IE纳入了回顾性研究。从病历中提取以下数据：社会人口学数据、死亡率、心内膜炎反复发作以及正在接受丁丙诺啡和美沙酮治疗的证据。药物使用对死亡率和心内膜炎反复发作的影响进行了研究，使用生存analysis.Results：总体而言，26人被纳入本研究。平均随访时间为45.0个月（SD 7.2，范围34.0-56.0）。在索引入院期间，8人接受丁丙诺啡，8人接受美沙酮，10人拒绝药物治疗。在随访期间，4例（15.4%）患者死亡，10例（38.5%）患者再次发生心内膜炎。生存分析的死亡率（对数秩P = 0.066）和心内膜炎的反复发作（对数秩P = 0.86）比较那些谁收到丁丙诺啡，接受美沙酮，并拒绝medication.Conclusions：单独开始药物治疗可能不足以影响长期死亡率和心内膜炎的反复发作率。需要更多的研究来确定注射IE药物的人的最佳治疗策略。
Objectives: Infective endocarditis (IE) among people who inject drugs is associated with high rates of mortality and repeat episodes of endocarditis. We sought to report on longer-term clinical outcomes of patients with IE who were offered buprenorphine or methadone treatment for opioid use disorder (OUD) at their initial hospital admission.Methods: Individuals with OUD hospitalized between 2013 and 2015 with IE were included for the retrospective study. The following data were extracted from the medical record: sociodemographic data, mortality, repeat episodes of endocarditis, and evidence of ongoing buprenorphine and methadone treatment. The impact of medication use on mortality and repeat episode of endocarditis was examined using survival analysis.Results: Overall, 26 individuals were included in the study. The mean duration of follow-up was 45.0 months (SD 7.2, range 34.0-56.0). During the index admission, 8 received buprenorphine, 8 received methadone, and 10 declined medications. During the follow-up period, 4 (15.4%) individuals died and 10 (38.5%) individuals experienced a repeat episode of endocarditis. Survival analysis of mortality (log-rank P = 0.066) and repeat episode of endocarditis (log-rank P = 0.86) comparing those who received buprenorphine, received methadone, and declined medication did not differ significantly.Conclusions: Initiation of medication treatment alone may not be sufficient to impact long-term mortality and rates of repeat episode of endocarditis. More research is needed to identify optimal treatment strategies for people who inject drugs with IE.