The effects of cocaine and heroin use on intubation rates and hospital utilization in patients with acute asthma exacerbations
The effects of cocaine and heroin use on intubation rates and hospital utilization in patients with acute asthma exacerbations
复制标题
DOI：
10.1378/chest.128.4.1951
复制
发表时间：
2005-10-01
期刊：
影响因子：
9.6
通讯作者：
Ansell, DA
中科院分区：
文献类型：
--
作者：
Levine, M;Iliescu, ME;Ansell, DA
背景：海洛因和可卡因的使用与哮喘加重有关。然而，这种影响的程度还没有得到充分的描述。本研究的目的是检验可卡因或海洛因使用与哮喘严重程度之间的关系。方法：我们对在市中心医院住院并随后因急性哮喘加重而出院的成年患者进行了回顾性图表回顾。如果患者在症状出现后24小时内承认使用可卡因，或获得阳性药物筛查结果，则将其归类为可卡因使用者。海洛因也采用了类似的分类。将可卡因和海洛因使用者与非使用者（即在症状出现前24小时内没有证据表明使用过任何一种药物的个体）的哮喘加重严重程度进行比较。结果：确定了166例独特的患者遭遇，并分析了152例患者记录。其中，27.6%（152例患者中的42例）使用可卡因伴或不含海洛因，被归类为可卡因使用者，而30.9%（152例患者中的47例）使用海洛因伴或不含可卡因，被归类为海洛因使用者。可卡因使用者比非使用者平均住院时间更长（3.4天vs 2.5天；p < 0.049）。可卡因使用者中插管和ICU住院比非可卡因使用者更常见（分别为21.4% vs 2.3% [p = 0.0006]; 31.0% vs 11.5% [p = 0.0068]）。海洛因使用者插管的频率也高于非海洛因使用者（分别为17.0%和2.3%;p = 0.0036）。在海洛因使用者和非海洛因使用者之间，住院时间和ICU入院比例均无显著差异。结论：海洛因和可卡因的使用在市中心医院的成年哮喘患者中很常见。可卡因和海洛因都与需要插管密切相关。基于这些发现，对到城市急诊科就诊的成人哮喘患者进行可卡因和海洛因使用筛查可能是谨慎的。
Background: The use of both heroin and cocaine has been associated with asthma exacerbations. However, the magnitude of this effect has not been adequately described. The purpose of this study was to examine the association between cocaine or heroin use and asthma severity.Methods: We conducted a retrospective chart review of adult patients who had been admitted to an inner-city hospital and who subsequently had received a hospital discharge diagnosis of acute asthma exacerbation. Patients were classified as cocaine users if they had admitted to using cocaine within 24 h of symptom onset, or if a positive drug screen result was obtained. A similar classification was employed for heroin. The severity of asthma exacerbations among cocaine and heroin users was compared to severity among nonusers (ie, individuals without evidence of having used either drug within the 24 h preceding symptom onset).Results: One hundred sixty-six unique patient encounters were identified, and 152 patient records were analyzed. Of these, 27.6% (42 of 152 patients) used cocaine with or without heroin and were classified as cocaine users, while 30.9% (47 of 152 patients) used heroin with or without cocaine and were classified as heroin users. Cocaine users had longer mean lengths of hospital stay than nonusers (3.4 days vs 2.5 days; p < 0.049). Intubation and ICU admission were more common among cocaine users than nonusers (21.4% vs 2.3%, respectively [p = 0.0006]; 31.0% vs 11.5%, respectively [p = 0.0068]). Heroin users were also intubated more frequently than nonusers (17.0% vs 2.3%, respectively; p = 0.0036). Neither the length of hospital stay nor the percentage of ICU admissions was significantly different between heroin users and nonusers.Conclusion: Heroin and cocaine use are common among adult asthmatic patients admitted to an inner-city hospital. Both cocaine and heroin are significantly associated with the need for intubation. Based on these findings, it may be prudent to screen adults with asthma presenting to an urban emergency department for cocaine and heroin use.