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

Title: Endocarditis, drug use and biological sex: A statewide analysis comparing sex differences in drug use-associated infective endocarditis with other drug-related harms.
Authors: McCrary LM; Washington University School of Medicine in St. Louis, Department of Medicine, 4523 Clayton Ave MSC 8051-0043-15, St. Louis, MO 63110.; Cox ME; North Carolina Department of Health and Human Services, Division of Public Health, 2001 Mail Service Center, Raleigh, NC 27699, USA.; Roberts KE; Bryn Mawr College, Graduate School of Social Work and Social Research, 300 Airdale Rd, Bryn Mawr, PA 19010, USA.; Knittel AK; University of North Carolina, Department of Obstetrics and Gynecology, 3009 Old Clinic Building, CB #7570, Chapel Hill, NC 27599, USA.; Jordan RA; University of North Carolina, Department of Psychiatry, 1101 Weaver Dairy Rd Ste 102, Chapel Hill 27514, USA.; Proescholdbell SK; North Carolina Department of Health and Human Services, Division of Public Health, 2001 Mail Service Center, Raleigh, NC 27699, USA.; Schranz AJ; University of North Carolina, Department of Medicine, 130 Mason Farm Rd, CB #7030, Chapel Hill, NC 27599, USA. Electronic address: aschranz@med.unc.edu.
Source: The International journal on drug policy [Int J Drug Policy] 2024 Jan; Vol. 123, pp. 104280. Date of Electronic Publication: 2023 Dec 15.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 9014759 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4758 (Electronic) Linking ISSN: 09553959 NLM ISO Abbreviation: Int J Drug Policy Subsets: MEDLINE
Imprint Name(s): Publication: 1998- : Amsterdam ; New York : Elsevier; Original Publication: Liverpool, England : International Journal on Drug Policy
MeSH Terms: Endocarditis*/epidemiology ; Endocarditis*/complications ; Substance-Related Disorders*/complications ; Hepatitis C*/epidemiology ; Hepatitis C*/complications ; Drug Overdose*/complications; Humans ; Male ; United States ; Female ; Pregnancy ; Retrospective Studies ; Sex Characteristics ; Hospitalization
Abstract: 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.; (Copyright © 2023. Published by Elsevier B.V.)
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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Grant Information: K12 HD103085 United States HD NICHD NIH HHS; K23 DA049946 United States DA NIDA NIH HHS; NU17CE925024 United States CE NCIPC CDC HHS
Contributed Indexing: Keywords: Endocarditis; Gender; Sex; Substance use
Entry Date(s): Date Created: 20231216 Date Completed: 20240117 Latest Revision: 20250104
Update Code: 20260130
PubMed Central ID: PMC10843756
DOI: 10.1016/j.drugpo.2023.104280
PMID: 38103457
Database: MEDLINE

Journal Article