Increasing Infectious Endocarditis Admissions Among Young People Who Inject Drugs

Alysse G Wurcel, Jordan E Anderson, Kenneth K H Chui, Sally Skinner, Tamsin A Knox, David R Snydman, Thomas J Stopka, Alysse G Wurcel, Jordan E Anderson, Kenneth K H Chui, Sally Skinner, Tamsin A Knox, David R Snydman, Thomas J Stopka

Abstract

People who inject drugs (PWID) are at risk for infective endocarditis (IE). Hospitalization rates related to misuse of prescription opioids and heroin have increased in recent years, but there are no recent investigations into rates of hospitalizations from injection drug use-related IE (IDU-IE). Using the Health Care and Utilization Project National Inpatient Sample (HCUP-NIS) dataset, we found that the proportion of IE hospitalizations from IDU-IE increased from 7% to 12.1% between 2000 and 2013. Over this time period, we detected a significant increase in the percentages of IDU-IE hospitalizations among 15- to 34-year-olds (27.1%-42.0%; P < .001) and among whites (40.2%-68.9%; P < .001). Female gender was less common when examining all the IDU-IE (40.9%), but it was more common in the 15- to 34-year-old age group (53%). Our findings suggest that the demographics of inpatients hospitalized with IDU-IE are shifting to reflect younger PWID who are more likely to be white and female than previously reported. Future studies to investigate risk behaviors associated with IDU-IE and targeted harm reduction strategies are needed to avoid further increases in morbidity and mortality in this rapidly growing population of young PWID.

Keywords: HIV; hepatitis C virus; hospitalization; infective endocarditis; people who inject drugs.

Figures

Figure 1.
Figure 1.
(A), Total annual number of injection drug use-related (IDU) infective endocarditis (IE) and IE hospitalizations between 2000 and 2013. (B) Annual percentage of IDU-IE hospitalizations by age, 2000 to 2013. (C) Annual percentage of IDU-IE hospitalizations by race, 2000 to 2013. (D) Annual percentage of IDU-IE hospitalizations among the 15–34 age group by race, 2000–2013.
Figure 2.
Figure 2.
Age distribution of injection drug use-related infective endocarditis hospitalizations by gender in 2002 (A), 2009 (B), and 2012 (C).

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Source: PubMed

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