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Title: Relation of substance use disorders to mortality, accident and emergency department attendances, and hospital admissions: A 13-year population-based cohort study in Hong Kong.
Austin Authors: Wei, Yue;Zhao, Jiaxi;Wong, Ian Ck;Wan, Eric Yf;Taylor, David McD ;Blais, Joseph E;Castle, David J;Knott, Jonathan C;Tse, Man Li;Chow, Anthony Ty;Chan, Esther W
Affiliation: Emergency
Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
Department of Critical Care, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
Emergency Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Hong Kong, China
Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
Centre for Addiction and Mental Health and the Department of Psychiatry, Toronto, Ontario, Canada
Hong Kong Poison Information Centre, United Christian Hospital, Hong Kong, China
The University of Hong Kong Shenzhen Institute of Research and Innovation, Shenzhen, Guangdong, China
Issue Date: 2021
Date: 2021-10-10
Publication information: Drug and alcohol dependence 2021; 229(Pt B): 109119
Abstract: The impact of substance use disorders (SUD) in an Asian population has not been fully explored. We aimed to assess the risk of mortality, accident and emergency (A&E) department attendances, and hospital admissions associated with SUD in a population-based cohort study. Patients diagnosed with SUD in public A&E departments from 2004 to 2016 (N = 8,423) were identified in the Clinical Database Analysis and Reporting System of the Hong Kong Hospital Authority and 1:1 matched to patients without SUD by propensity score (N = 6,074 in each group). Relative risks of mortality, A&E attendances and hospital admissions were assessed using Cox regression and Hurdle negative binomial regression. Patients with SUD had higher mortality (hazard ratio=1.43; 95% confidence interval [CI]=1.26-1.62) and more often died from poisoning or toxicity and injuries. The odds ratio (OR) for A&E attendances and all-cause hospital admissions associated with SUD were 2.80 (95% CI=2.58-3.04) and 3.54 (95% CI=3.26-3.83), respectively. The impact of SUD on the above outcomes was greatest among school-aged individuals (≤ 21 years) and decreased with age. The relative risk of mental disorder-related hospital admissions was much higher than that for infections, respiratory diseases, and cardiovascular diseases. In patients with SUD, ketamine and amphetamine use were associated with increased A&E attendances than opioid use. SUD was associated with increased mortality, A&E attendances and hospital admissions, especially in school-aged individuals. Our findings suggest prioritising early treatment and preventive interventions for school-aged individuals and focusing on the management of comorbid mental disorders and the use of ketamine and amphetamine.
DOI: 10.1016/j.drugalcdep.2021.109119
Journal: Drug and Alcohol Dependence
PubMed URL: 34717115
Type: Journal Article
Subjects: Accident and emergency department attendances
Hospital admissions
Substance use disorders
Appears in Collections:Journal articles

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