Aortic Valve Surgery Outcomes Reporting and Implications for Persons Who Use Drugs With Infectious Endocarditis.
Aortic Valve Surgery Outcomes Reporting and Implications for Persons Who Use Drugs With Infectious Endocarditis.
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主动脉瓣手术结果报告以及对使用药物治疗感染性心内膜炎的人的影响。
DOI：
10.1093/cid/ciz837
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Springer,SandraA
中科院分区：
文献类型：
--
作者：
Springer,SandraA
Kimmel SD 等人在本期《临床传染病》杂志上发表的最新研究，对 2013 年开始公开报告主动脉瓣 (AV) 手术结果前后的美国注射吸毒 (IDU) 相关感染性心内膜炎 (IE) (IDU-IE) 和非 IDU IE 住院样本进行了中断时间序列分析，该研究发现了一些从公共卫生角度具有相关意义的重要发现。在本次评估中，将 2013 年国家报告制度建立之前（2010-2012 年）到该政策颁布之后（2013 年 8 月-2015 年）期间 IDU-IE 住院患者的 IE 入院率、AV 手术率和院内死亡率与非 IDU IE 患者进行了比较。本研究利用了国家住院患者样本 (NIS) 数据库中的国际疾病分类第九版 (ICD-9) 编码数据。在美国阿片类药物 [2, 3] 和非阿片类药物过量 [4] 流行病不断恶化的背景下，注射吸毒者相关感染 [1] 急剧增加，凸显了进行这项分析的重要性。正如 Kimmel 等人所强调的，医学界担心，由于吸毒者 (PWUD) 中细菌和真菌感染性心内膜炎诊断率的上升[5, 6]，由于担心持续吸毒以及瓣膜手术后再感染的风险和其他偏见，外科医生可能不太愿意进行手术 [7, 8]。因此，评估公开报告 IDU-IE 对获得挽救生命的瓣膜手术的能力的潜在负面影响非常重要。在这项研究中，作者首先表明，因 IE 导致的住院率总体从 2013 年国家报告之前的 18.3% 上升到国家报告期之后的 27.3%。这些增加发生在那些年龄较小、白人、居住在较贫困社区、接受医疗补助以及因非选择性原因入院的人中。这些发现反映了在该国阿片类药物和非阿片类药物流行的背景下，残疾人感染率上升的趋势[1, 9-13] [2, 3, 9]。尽管 IDU 和非 IDU IE 入院人数在此期间有所增加，但与国内报告时间段相比，IDU-IE 入院人数主要由年轻、白人、女性和接受医疗补助的人组成。这项研究强调了 2014 年（即国家报告制定一年后）医疗补助扩张的重要性。如果 2014 年不扩大医疗补助计划，医院很可能
In their interrupted time series analysis of a sample of US inpatient hospitalizations of injection drug use (IDU) related infectious endocarditis (IE)(IDU-IE) and non-IDU IE before and after public reporting of aortic valve (AV) surgery outcomes was instituted in 2013, Kimmel SD et al’s current study published in this issue of Clinical Infectious Diseases identified some important findings that have relevant implications from a public health standpoint. In this evaluation, hospital admissions for IE, AV surgeries, and in-hospital mortality among persons hospitalized with IDU-IE were compared to those with non-IDU IE in a time period before (2010–2012) the national reporting system was instituted in 2013 to after this policy was enacted (August of 2013–2015). This study utilized International Classification of Diseases, 9th Revision (ICD-9) coding data from the National Inpatient Sample (NIS) database. The importance of undertaking this analysis is underscored by dramatic increases in IDU-related infections [1] in the setting of ever-worsening epidemics of opioid [2, 3] and non-opioid overdoses [4] in the United States. As highlighted by Kimmel et al, concern has been raised in the medical community that because of a rise in bacterial and fungal infective endocarditis diagnoses among persons who use drugs (PWUD)[5, 6], surgeons may be less inclined to perform surgery due to concern for ongoing drug use and risk of reinfection after valve surgery and other biases [7, 8]. Thus evaluating the potential negative impact of public reporting of IDU-IE on the ability to obtain life-saving valve surgery is important to understand.In this study, first the authors showed that hospital admissions due to IE overall rose from 18.3% in the period before the national reporting occurring in 2013 to 27.3% after the institution of the national reporting period. These increases occurred among those who were younger, of white race, living in poorer neighborhoods, in receipt of Medicaid, and were admitted for nonelective reasons. These findings mirror national trends of rising infections among PWUD [1, 9–13] in the setting of the opioid and nonopioid drug epidemics in this country [2, 3, 9]. Although both IDU and non-IDU IE hospital admissions increased during these periods, the IDU-IE admissions were predominately composed of those who were young, white, female, and receiving Medicaid compared to prenational reporting time periods. This study highlights the importance of Medicaid expansion that occurred in 2014, a year after the national reporting was instituted. It is likely that without Medicaid expansion in 2014, the hospital
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海洛因过量死亡人数增加——28 个州，2010 年至 2012 年
DOI：
--
发表时间：
2014
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
R. A. Rudd;L. Paulozzi;M. Bauer;Richard W. Burleson;Rick E. Carlson;Dan Dao;James W. Davis;J. Dudek;B. Eichler;Jessie C Fernandes;Anna Fondario;B. Gabella;Beth Hume;Theron Huntamer;M. Kariisa;T. Largo;JoAnne Miles;Ashley Newmyer;Daniela K. Nitcheva;B. Pérez;Scott K. Proescholdbell;Jennifer C. Sabel;Jessica Skiba;S. Slavova;Kathy Stone;John M. Tharp;T. Wendling;Dagan Wright;Anne Zehner
通讯作者：
Anne Zehner
影响因子：
33.9
作者：
Cranston, Kevin;Alpren, Charles;Demaria, Alfred, Jr.
通讯作者：
Demaria, Alfred, Jr.
DOI：
10.1097/01.blo.0000534682.68856.d8
发表时间：
2018-08-01
影响因子：
4.2
作者：
Oh, David Hyung Won;Wurcel, Alysse Gail;Salzler, Matthew Joseph
通讯作者：
Salzler, Matthew Joseph
阿片类药物使用障碍和传染病流行交叉点的综合应对措施
影响因子：
7.3
作者：
Annabel Nicholson
通讯作者：
Annabel Nicholson
《感染性心内膜炎手术治疗共识指南》：外科医生必须带头。
影响因子：
6
作者：
G. Vlahakes
通讯作者：
G. Vlahakes