Dataset Information

A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida.

ABSTRACT:

Background

Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs). Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence of HIV and hepatitis C virus among this cohort of hospitalized IDUs was estimated.

Methods and findings

IDUs discharged from Jackson Memorial Hospital were identified using the International Classification of Diseases, Ninth Revision, codes for illicit drug abuse and endocarditis, bacteremia or sepsis, osteomyelitis and skin and soft tissue infections (SSTIs). 349 IDUs were identified for chart abstraction and 92% were either uninsured or had publicly funded insurance. SSTIs, the most common infection, were reported in 64% of IDUs. HIV seroprevalence was 17%. Seventeen patients (4.9%) died during their hospitalization. The total cost for treatment for injection drug use-related infections to Jackson Memorial Hospital over the 12-month period was $11.4 million.

Conclusions

Injection drug use-related bacterial infections represent a significant morbidity for IDUs in Miami-Dade County and a substantial financial cost to the county hospital. Strategies aimed at reducing risk of infections associated with injection drug use could decrease morbidity and the cost associated with these common, yet preventable infections.

SUBMITTER: Tookes H

PROVIDER: S-EPMC4468183 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida.

Tookes Hansel H Diaz Chanelle C Li Hua H Khalid Rafi R Doblecki-Lewis Susanne S

PloS one 20150615 6

<h4>Background</h4>Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs). Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the preva ...[more]

PMID: 26075888

Similar Datasets

Project description:Urbanization is increasing globally, and construction sites are an integral part of the urbanization process. It is unknown to what extent construction sites create favorable breeding conditions for mosquitoes. The main objectives of the present study were to identify what species of mosquitoes are present at construction sites and the respective physical features associated with their production. Eleven construction sites were cross-sectionally surveyed for the presence of mosquitoes in Miami-Dade County, Florida including in areas previously affected by the Zika virus outbreak in 2016. A total of 3.351 mosquitoes were collected; 2.680 adults and 671 immatures. Aedes aegypti and Culex quinquefasciatus comprised 95% of all collected mosquitoes and were the only species found in their immature forms breeding inside construction sites. Results for the Shannon and Simpson indices, considering both immature and adult specimens, yielded the highest values for Cx. quinquefasciatus and Ae. aegypti. The individual rarefaction curves indicated that sampling sufficiency was highly asymptotic for Cx. quinquefasciatus and Ae. aegypti, and the plots of cumulative species abundance (ln S), Shannon index (H) and log evenness (ln E) (SHE) revealed the lack of heterogeneity of species composition, diversity and evenness for the mosquitoes found breeding in construction sites. The most productive construction site breeding features were elevator shafts, Jersey plastic barriers, flooded floors and stair shafts. The findings of this study indicate that vector mosquitoes breed in high numbers at construction sites and display reduced biodiversity comprising almost exclusively Ae. aegypti and Cx. quinquefasciatus. Such findings suggest that early phase construction sites have suitable conditions for the proliferation of vector mosquitoes. More studies are needed to identify modifiable worker- and organizational-level factors to improve mosquito control practices and guide future mosquito control strategies in urban environments.

Project description:BackgroundSepsis mortality has remained unchanged for greater than a decade, and early recognition continues to be the most important factor in mortality outcome. Plasma resistin concentration is increased in sepsis, but its mechanism and clinical relevance is unclear. As one function, resistin interacts with toll-like receptor 4 in competition with lipopolysaccharide, a main component of the gram-negative bacterial cell wall. It is not known if the type of infection leading to sepsis influences resistin production. The objective of this study was to investigate whether 1) early plasma resistin concentration can predict mortality, 2) elevated plasma resistin concentration is associated with clinical disease severity scores, such as SOFA, mSOFA and APACHE II, and 3) plasma resistin concentrations differ between gram negative versus other etiologies of sepsis.MethodsThis was an exploratory study in the framework of a prospective observational design. Peripheral venous blood samples were obtained from subjects admitted to the intensive care unit at clinical recognition of sepsis (0 hour) and at 6 and 24 hours. Vasopressor utilization was not a requirement for inclusion. Plasma was analyzed for resistin concentration by ELISA. Cytokine concentrations including IL-6, IL-8, and IL-10 were determined by cytokine bead array. Cytokine data were evaluated against publicly available sepsis RNA expression datasets to compare protein versus RNA expression levels in predicting clinical disease state. Clinical data were collected from electronic health records for clinical severity index calculations and context for interpretation of resistin and cytokine concentrations. Subjects were followed up to 60 days, or until death, whichever came first. Statistical analysis was completed with R package and SPSS software.ResultsResistin levels were elevated in subjects admitted to the intensive care unit with sepsis. Four-hundred subjects were screened with 45 subjects included in the final analysis. Thirteen of 45 patients were non-survivors. Mortality within 60 days correlated with significantly higher resistin concentrations than in survivors. A resistin concentration of >126 ng/mL at clinical recognition of sepsis and >197 ng/mL within the first 24 hours were associated with mortality within 60 days with an area under the curve of 0.82 and 0.88, respectively. Most subjects with resistin concentration greater than these threshold values were deceased prior to 30 days. Resistin concentrations correlated with SOFA, mSOFA, and APACHE II scores in addition to having association with increases in inflammatory and sepsis biomarkers. These associations were validated with analysis of RNA expression datasets.ConclusionPlasma resistin concentrations of >126 ng/mL at clinical recognition of sepsis and >197 ng/mL within the first 24 hours of clinical sepsis recognition are associated with all-cause mortality. Resistin concentration within this timeframe also has comparable mortality association to well-validated clinical severity indices of SOFA, mSOFA, and APACHE II scores.

Dataset Information

A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida.

Background

Methods and findings

Conclusions

Publications

A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets