Home > Cross-sectional study of the characteristics, healthcare usage, morbidity and mortality of injecting drug users attending an inner city emergency department.

O'Connor, Gerard and McGinty, Tara and Yeung, Sarah Jane and O'Shea, Daire and Macken, Alan and Brazil, Eamon and Mallon, Patrick (2014) Cross-sectional study of the characteristics, healthcare usage, morbidity and mortality of injecting drug users attending an inner city emergency department. Emergency Medicine Journal , 31 , (8) , pp. 625-629.

Background: The affliction of injecting drug use (IDU) has resulted in the emergence of a subgroup of people with a unique set of medical issues. We aimed to describe the emergency department (ED) presentations of IDUs.

Methods: In a prospective observational study over a 3-month period, we identified characteristics of patients with a history of active IDU presenting to the ED.

Results: From 1 January 2010 to 31 March 2010, 146 patients with a history of IDU were identified. These contributed to 222 acute presentations to the ED. Baseline characteristics revealed that patients were predominantly male, of Irish nationality, with high levels of homelessness, unemployment and lack of stable family or intimate partner relationships. 45% of presentations occurred as a result of infection (95% CI 38.5% to 51.5%). Trauma, pure toxicological issues, thromboembolic phenomena and psychiatric issues comprised the other common acute diagnoses. The burden of comorbid medical illness was substantial with high rates of hepatitis C infection (74%) and HIV infection (13.8%). Healthcare utilisation indices for this cohort are extreme on multiple measures. We found an ED attendance rate of 445 per 100 patient-years, an admission rate of 68.8 per 100 patient-years and mortality rate of 4.86 per 100 patient-years.

Conclusions Our study characterises the emergency presentations of active IDUs. We describe considerable acute and chronic medical consequences and high healthcare utilisation associated with IDU. This study is of particular relevance to any institution that provides acute medical care to this group of patients.


Item Type:Article
Date:2014
Page Range:pp. 625-629
Publisher:BMJ Publishing
Volume:31
Number:8
EndNote:View
Accession Number:HRB (Electronic Only)
Related URLs:
Subjects:A Substance use, abuse, and dependence > Effects and consequences
G Health and disease > State of health
G Health and disease > Disorder by cause > Communicable disease > Hepatitis C
G Health and disease > Disorder by cause > Emotional trauma
J Health care, prevention and rehabilitation > Care by type of problem > Emergency care
J Health care, prevention and rehabilitation > Health care delivery
P Demography, epidemiology, and history > Population dynamics > Substance related mortality / death
T Demographic characteristics > Person who uses substances (user)
T Demographic characteristics > Person who injects drugs (Intravenous / injecting)
VA Geographic area > Europe > Ireland > Dublin

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