1022. Rising Rates of Injection Drug Use Associated Infective Endocarditis in Virginia With Missed Opportunities for Injection Drug Use Disorder Treatment Referral: A Retrospective Cohort Study. (26th November 2018)

• Record Type: Journal Article
• Authors: Gray, Megan; Rogawski, Elizabeth; Scheld, Michael W; Dillingham, Rebecca
• Is Part Of: Open forum infectious diseases. Volume 5(2018)Supplement 1
• Page Start: S304
• Page End: S305
• Publication Date: 2018-11-26
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofy210.859
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Injection drug use disorder (IDD) is a growing public health threat in Virginia, although there is limited knowledge of related morbidity. The purpose of this study was to describe the temporal, geographic, and clinical trends and characteristics of infective endocarditis associated with IDD (IDD-IE) and to identify opportunities for better-quality care of people with IDD. Methods: We reviewed charts for all admissions coded for both IE and drug use disorders at the University of Virginia Medical Center (UVA) from January 2000 to July 2016. A random sample of 30 admissions coded for IE per year were reviewed to evaluate temporal trends in the proportion of IDD associated IE cases. Results: There were a total of 76 patients with IDD-IE during the study period, with a 7-fold increase in cases of IDD-IE from the early 2000s to 2016. The proportion of IE that was IDD-associated increased by nearly 10% each year (prevalence ratio of IDD per year: 1.09, 95% CI: 1.05–1.14). Patients with IDDIE had longer hospital stays [median days (interquartile range); IDD-IE, 17 (10–29); non-IDD-IE, 10 (6–18); P = 0.001] with almost twice the cost of admission as those without IDD [median (interquartile range); IDD-IE, $47, 899 ($24, 578–78, 144); non-IDD-IE, $26, 460 ($10, 220–60, 059); P = 0.001]. In 52% of cases, there was no documentation of any discussion regarding addiction treatment. Conclusion: IDD-IE cases are increasing in Virginia leading to higher morbidity and healthcare costs. IDD-IE may provide an opportunity for the delivery of IDD treatment, counseling, and harm reduction strategies. Disclosures: All authors: No reported disclosures.