Substances used and OAT (Opioid agonist therapy).

Injection drug use poses a public health challenge. Clinical experience indicates that people who inject drugs (PWID) are hospitalized frequently for infectious diseases, but little is known about outcomes when admitted. Charts were identified from local hospitals between 2013–2018 using consultation lists and hospital record searches. Included individuals injected drugs in the past six months and presented with infection. Charts were accessed using the hospital information system, undergoing primary and secondary reviews using Research Electronic Data Capture (REDCap). The Wilcoxon rank-sum test was used for comparisons between outcome categories. Categorical data were summarized as count and frequency, and compared using Fisher’s exact test. Of 240 individuals, 33% were admitted to the intensive care unit, 36% underwent surgery, 12% left against medical advice (AMA), and 9% died. Infectious diagnoses included bacteremia (31%), abscess (29%), endocarditis (29%), cellulitis (20%), sepsis (10%), osteomyelitis (9%), septic arthritis (8%), pneumonia (7%), discitis (2%), meningitis/encephalitis (2%), or other (7%). Sixty-six percent had stable housing and 60% had a family physician. Fifty-four percent of patient-initiated discharges were seen in the emergency department within 30 days and 29% were readmitted. PWID are at risk for infections. Understanding their healthcare trajectory is essential to improve their care.

注射药物使用是一项公共卫生挑战。临床经验表明，注射毒品者（People Who Inject Drugs，PWID）常因感染性疾病频繁住院，但目前对其入院后的临床转归情况仍知之甚少。研究人员通过咨询清单与医院记录检索，于2013至2018年间从本地医院中筛选出符合研究纳入标准的病例：受试者需在过去6个月内有注射毒品史，且因感染性疾病就诊。研究人员通过医院信息系统调取病例资料，并利用研究电子数据采集系统（Research Electronic Data Capture，REDCap）开展一级与二级数据复核。本研究采用Wilcoxon秩和检验对不同转归类别进行比较分析；分类数据以例数与频率进行汇总，并通过Fisher精确检验完成组间比较。本次研究共纳入240名受试者，其中33%被收入重症监护病房，36%接受手术治疗，12%的患者自行出院（against medical advice，AMA），9%的受试者死亡。感染性诊断涵盖菌血症（31%）、脓肿（29%）、心内膜炎（29%）、蜂窝织炎（20%）、脓毒症（10%）、骨髓炎（9%）、化脓性关节炎（8%）、肺炎（7%）、椎间盘炎（2%）、脑膜炎/脑炎（2%）及其他感染（7%）。66%的受试者拥有稳定住房，60%配备家庭医生。在自行出院的患者中，54%于出院后30天内前往急诊科复诊，29%再次入院。注射毒品者面临较高的感染性疾病风险，明晰其医疗照护轨迹对优化诊疗服务至关重要。