Increasing Infectious Endocarditis Admissions Among Young People Who Inject Drugs

TLDR

People who inject drugs are at risk for infective endocarditis, and although opioid‑related hospitalization rates have risen, recent data on injection‑drug‑use‑related IE admissions are lacking. The study calls for future research into risk behaviors and harm‑reduction strategies to curb morbidity and mortality among the growing cohort of young PWID. Using the HCUP‑NIS national inpatient sample, the authors quantified a rise in IE hospitalizations attributable to injection drug use from 7 % to 12.1 % between 2000 and 2013. IDU‑IE admissions increased markedly among 15‑34‑year‑olds (27.1 %–42.0 %) and whites (40.2 %–68.9 %), with females less common overall but more frequent in the younger age group, indicating a shift toward younger, white, female patients.

Abstract

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.