Hospital Admissions for Chest Pain Associated with Cocaine Use in the United States
| Autor: | Jeffrey J. Goldberger, Carlos Alfonso, Vikas Singh, Raul D. Mitrani, Badal Thakkar, Mauricio G. Cohen, Apurva Badheka, Nileshkumar J. Patel, Ghanshyambhai T. Savani, Alex P. Rodriguez, Juan F. Viles-Gonzalez |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Acute coronary syndrome Chest Pain Adolescent medicine.medical_treatment Myocardial Infarction 030204 cardiovascular system & hematology Chest pain 03 medical and health sciences Cocaine-Related Disorders Young Adult 0302 clinical medicine Percutaneous Coronary Intervention Cost of Illness Risk Factors Internal medicine medicine Humans Myocardial infarction Hospital Mortality Stroke Aged business.industry Percutaneous coronary intervention 030208 emergency & critical care medicine General Medicine Odds ratio Tobacco Use Disorder Middle Aged medicine.disease Surgery Hospitalization Cardiovascular Diseases Heart failure Heart catheterization Female medicine.symptom business |
| Zdroj: | The American journal of medicine. 130(6) |
| ISSN: | 1555-7162 2001-2012 |
| Popis: | The outcomes related to chest pain associated with cocaine use and its burden on the healthcare system are not well studied.Data were collected from the Nationwide Inpatient Sample (2001-2012). Subjects were identified by using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Primary outcome was a composite of mortality, myocardial infarction, stroke, and cardiac arrest.We identified 363,143 admissions for cocaine-induced chest pain. Mean age was 44.9 (±21.1) years with male predominance. Left heart catheterizations were performed in 6.7%, whereas the frequency of acute myocardial infarction and percutaneous coronary interventions were 0.69% and 0.22%, respectively. The in-hospital mortality was 0.09%, and the primary outcome occurred in 1.19% of patients. Statistically significant predictors of primary outcome included female sex (odds ratio [OR], 1.16; confidence interval [CI], 1.00-1.35; P = .046), age50 years (OR, 1.24, CI, 1.07-1.43; P = .004), history of heart failure (OR, 1.63, CI, 1.37-1.93; P.001), supraventricular tachycardia (OR, 2.94, CI, 1.34-6.42; P = .007), endocarditis (OR, 3.5, CI, 1.50-8.18, P = .004), tobacco use (OR, 1.3, CI, 1.13-1.49; P.001), dyslipidemia (OR, 1.5, CI, 1.29-1.77; P.001), coronary artery disease (OR, 2.37, CI, 2.03-2.76; P .001), and renal failure (OR, 1.27, CI, 1.08-1.50; P = .005). The total annual projected economic burden ranged from $155 to $226 million with a cumulative accruement of more than $2 billion over a decade.Hospital admissions due to chest pain and concomitant cocaine use are associated with low rates of adverse outcomes. For the low-risk cohort in whom acute coronary syndrome has been ruled out, hospitalization may not be beneficial and may result in unnecessary cardiac procedures. |
| Databáze: | OpenAIRE |
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