Impact of medications for opioid use disorder among persons hospitalized for drug use-associated skin and soft tissue infections.
Impact of medications for opioid use disorder among persons hospitalized for drug use-associated skin and soft tissue infections.
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DOI：
10.1016/j.drugalcdep.2020.108207
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发表时间：
2020-10-01
影响因子：
4.2
通讯作者：
Linas BP
中科院分区：
文献类型：
--
作者：
Barocas JA;Gai MJ;Amuchi B;Jawa R;Linas BP
皮肤和软组织感染（SSTI）是注射吸毒的常见并发症。我们的目的是确定阿片类药物使用障碍（OUD）住院治疗SSTI的患者在出院后30天内开始接受MOUD治疗和未接受MOUD治疗的患者之间是否存在再住院和复发性SSTI的差异。我们对2010年至2017年美国18岁及以上的商业保险成年人进行了回顾性分析，这些成年人患有OUD并因注射相关SSTI住院。主要暴露是在因SSTI住院后30天内开始MOUD。主要结局包括30天和1年1）全因再住院和2）复发性SSTI。我们计算了两组的发生率：MOUD组和无MOUD组的主要结局。我们开发了考克斯模型来确定两组之间再住院和复发性SSTI是否存在差异。只有5.5%（357/6538）的人在指数SSTI住院后的一个月内接受了MOUD。30-与无MOUD组相比，MOUD组的再住院发生率更高（35.9 vs 27.5/100人-30天），1年SSTI复发率更低（10.3 vs 18.7/100人-年）。在多变量建模中，与无MOUD组相比，MOUD组30天再住院的风险显著较高，一年SSTI复发的风险较低。SSTI住院后接受MOUD治疗可降低OUD患者复发SSTI的风险。进一步扩大这些住院服务可以为美国应对阿片类药物流行提供有效工具。
Skin and soft tissue infections (SSTI) are common complications of injection drug use. We aimed to determine if rehospitalization and recurrent SSTI differ among persons with opioid use disorder (OUD) hospitalized for SSTI who are initiated on MOUD within 30 days of discharge and those who are not. We performed a retrospective analysis of commercially insured adults aged 18 years and older in the U.S. with OUD and hospitalization for injection-related SSTI from 2010-2017. The primary exposure was initiation of MOUD in the 30 days following hospitalization for SSTI. The primary outcomes included 30-day and 1-year 1) all-cause rehospitalization and 2) recurrent SSTI. We calculated the incidence rates for the two groups: MOUD group and no MOUD group for the primary outcomes. We developed Cox models to determine if rehospitalization and recurrent SSTI differ between the two groups. Only 5.5% (357/6538) of people received MOUD in the month following their index SSTI hospitalization. 30-day rehospitalization incidence was higher in the MOUD group compared to no MOUD (35.9 vs 27.5 per 100 person-30 days) and one-year SSTI recurrence was lower (10.3 vs 18.7 per 100 person-years). In multivariable modeling, the MOUD group remained at significantly higher risk of 30-day rehospitalization compared to the no MOUD group and at lower risk for one-year SSTI recurrence. MOUD receipt following SSTI hospitalization decreases risk of recurrent SSTI among persons with OUD. Further expansion of these in-hospital services could provide an effective tool in the U.S. response to the opioid epidemic.
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影响因子：
33.9
作者：
Cranston, Kevin;Alpren, Charles;Demaria, Alfred, Jr.
通讯作者：
Demaria, Alfred, Jr.
影响因子：
158.5
作者：
Peters, Philip J.;Pontones, Pamela;Duwve, Joan M.
通讯作者：
Duwve, Joan M.
影响因子：
33.9
作者：
Golden, Matthew R.;Lechtenberg, Richard;Buskin, Susan E.
通讯作者：
Buskin, Susan E.
DOI：
10.1377/hlthaff.2015.1424
发表时间：
2016-05-01
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Ronan MV;Herzig SJ
通讯作者：
Herzig SJ
影响因子：
4.2
作者：
Monteiro, Jordanna;Phillips, Kristina T.;Stein, Michael D.
通讯作者：
Stein, Michael D.