Endocarditis, drug use and biological sex: A statewide analysis comparing sex differences in drug use-associated infective endocarditis with other drug-related harms

Details

• Alternative Title:
  Int J Drug Policy
• Personal Author:
  McCrary, L. Madeline ; Cox, Mary E. ; Roberts, Kate E. ; Knittel, Andrea K. ; Jordan, Robyn A. ; Proescholdbell, Scott K. ; Schranz, Asher J.
• Description:
  Objectives:
  
  Hospitalizations for drug use-associated infective endocarditis (DUA-IE) have risen sharply across the United States over the past decade. The sex composition of DUA-IE remains less clear, and studies have indicated a possible shift to more females. We aimed to compare more recent statewide hospitalization rates for DUA-IE in females versus males and contextualize them among other drug-related harms in North Carolina (NC).
  
  Methods:
  
  This study was a retrospective analysis using public health datasets of all NC hospital discharges for infective endocarditis from 2016 to 2020. Drug use-related hospitalizations were identified using ICD-10-CM codes. Discharge rates by year and sex for DUA-IE and non-DUA-IE were calculated and compared to fatal overdoses and acute hepatitis C (HCV). Temporal, demographic, and pregnancy trends were also assessed.
  
  Results:
  
  Hospitalizations rates for DUA-IE were 9.7 per 100,000 over the five-year period, and 1.2 times higher among females than males. Females composed 57% of DUA-IE hospitalizations over the period. Conversely, fatal overdose, acute HCV, and non-DUA-IE hospitalization rates were higher among males. Age, county of residence, and pregnancy status did not explain the higher DUA-IE among females.
  
  Conclusion:
  
  Females now comprise the majority of DUA-IE hospitalizations in NC, unlike other drug-related harms. No clear demographic or geographic associations were found, and further research is needed to explain this phenomenon. Preventing invasive infections among females who inject drugs should be prioritized.
  
  
• Subjects:
  Drug Overdose Endocarditis Female Hepatitis C Hospitalization Humans Male Pregnancy Retrospective Studies Sex Characteristics Substance-Related Disorders United States

  More +
• Keywords:
  Endocarditis Gender Sex Substance Use
• Source:
  Int J Drug Policy. 123:104280
• Pubmed ID:
  38103457
• Pubmed Central ID:
  PMC10843756
• Document Type:
  Journal Article
• Funding:
  K12 HD103085/HD/NICHD NIH HHSUnited States/ ; K23 DA049946/DA/NIDA NIH HHSUnited States/ ; NU17CE925024/CE/NCIPC CDC HHSUnited States/
• Volume:
  123
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:d5f77f1eb236b5ff8200f0ef54777d1c4936f2a2d716a435961d1edb3570aaf15934d8d123f5585ae8ca123260b3d309dd48ebeaa66f6e84cd3fe764b5e44054
• Download URL:
  https://stacks.cdc.gov/view/cdc/147734/cdc_147734_DS1.pdf
• File Type:
  [PDF - 172.56 KB ]