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Temporal Trends in Drug Abuse in Adults with Acute Myocardial Infarction Show Worse Outcomes

Published online by Cambridge University Press:  23 March 2020

Z. Mansuri ,
S. Patel ,
P. Patel ,
O. Jayeola ,
A. Das ,
J. Shah ,
M.H. Gul ,
K. Karnik ,
A. Ganti  and
R. Patel
Z. Mansuri
Affiliation:
Texas Tech University Health Sciences Center Permian Basin Campus, Psychiatry, Odessa, USA
S. Patel
Affiliation:
Icahn School of Medicine at Mount Sinai, Public Health, New York, USA
P. Patel
Affiliation:
Windsor University School of Medicine, Public Health, Monee, USA
O. Jayeola
Affiliation:
Drexel University School of Public Health, Public Health, Philadephia, USA
A. Das
Affiliation:
Florida Hospital, Internal Medicine, Orlando, USA
J. Shah
Affiliation:
Pramukhswami Medical College, Internal Medicine, Karamsad, India
M.H. Gul
Affiliation:
St. Louis University Hospital, Nephrology, St. Louis, USA
K. Karnik
Affiliation:
Children's Hospital of San Antonio, Public Health, San Antonio, USA
A. Ganti
Affiliation:
Suburban Medical Center, Internal Medicine, Schaumburg, USA
R. Patel
Affiliation:
Acardia University, Public Health, Glenside, USA

Abstract

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Objective

To determine temporal trends, invasive treatment utilization and impact on outcomes of pre-infarction drug abuse (DA) on acute myocardial infarction (AMI) in adults.

Background

DA is important risk factor for AMI. However, temporal trends in drug abuse on AMI hospitalization outcomes in adults are lacking.

Methods

We used Nationwide Inpatient Sample (NIS) from Healthcare Cost and Utilization Project (HCUP) from 2002 to 2012. We identified AMI and DA as primary and secondary diagnosis respectively using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD9CM) codes, and used the CochraneArmitage trend test and multivariate regression to generate adjusted odds ratios (aOR).

Results

We analyzed total of 7,174,274 AMI hospital admissions from 2002 to 2012 of which 1.67% had DA. Proportion of hospitalizations with DA increased from 5.63% to 12.08% (P trend < 0.001). Utilization of coronary artery bypass grafting (CABG) was lower in patients with DA (7.83% vs. 9.18%, P < 0.001). In-hospital mortality was significantly lower in patients with DA (aOR 0.811; 95% CI 0.693–0.735; P < 0.001) but discharge to specialty care was higher (aOR 1.076; 95% CI 1.025–1.128; P < 0.001). The median cost of hospitalization (40,834 vs. 37,253; P < 0.001) was higher in hospitalizations with DA.

Conclusions

We demonstrate an increasing proportion of adults admitted with AMI have DA over the decade. However, DA has paradoxical association with mortality in adults. DA is associated with lower CABG utilization and higher discharge to specialty care, with a higher mean cost of hospitalization. The reasons for the paradoxical association of DA with mortality and worse morbidity outcomes need to be explored in greater detail.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Epidemiology and social psychiatry
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. s247
Copyright
Copyright © European Psychiatric Association 2017
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