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The University of Louisville Journal of Respiratory Infections

Abstract

Background: Intravenous drug users (IVDU) have a 10-fold increased risk of community-acquired pneumonia (CAP) compared to the general population. There is scarce data available evaluating the clinical outcomes of IVDU hospitalized patients with CAP and that data mostly focuses on mortality. The objective of this study was to evaluate the clinical characteristics, incidence and outcomes of hospitalized patients with CAP in active intravenous drug users in Louisville, Kentucky.

Methods: This was a secondary data analysis of the University of Louisville Pneumonia study. IVDU patients were propensity score matched to a non-IVDU group. Study outcomes were time to clinical stability (TCS), length of stay (LOS), mortality at discharge, and mortality at 1 year. Stratified Cox proportional hazard regression was performed to evaluate TCS and LOS. Conditional logistic regression was performed to evaluate mortality. Statistical significance was defined as p ≤ 0.05.

Results: From a total of 8,284 hospitalized patients with CAP reviewed, 113 patients were matched per group. Median (IQR) age for the IVDU was 33 (28-43) versus 36 (28-48) for the matched non-IVDU group (p<0.001). Analysis showed no association with TCS (stratified hazard ratio (sHR): 0.81; 95% CI: 0.58-1.14; p=0.227), LOS (sHR: 0.71; 95% CI: 0.50-1.01; p=0.053), mortality at discharge (conditional odds ratio (cOR): 1.67; 95% CI: 0.40-6.97; p=0.484) and mortality at 1 year (cOR: 1.125; 95% CI: 0.43-2.92; p=0.808).

Conclusions: This study shows that active IVDU hospitalized patients with CAP do not have worse outcomes when compared with non-IVDU hospitalized patients with CAP. Patients in the IVDU group were significantly younger. Since severity scores commonly used are heavily influenced by age, these will not likely be useful tools to assist the physicians with the site for care and management.

Funder

Study was supported primarily by the Division of Infectious Diseases, University of Louisville, Kentucky

DOI

10.18297/jri/vol2/iss2/3/

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