Abstract 18800: Nationwide Analysis on the Impact of Drug and Alcohol Abuse on Inpatient Outcomes of Patients With Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention
Background: Drug and alcohol abuse are highly prevalent in the U.S. and associated with significant number of hospital admissions and emergency department visits. The aim of this study is to evaluate the impact of drug and alcohol abuse on outcomes in patients with Acute Myocardial Infarction (AMI) who undergo percutaneous coronary intervention (PCI).
Methods: This is a retrospective analysis utilizing the 2014 Nationwide Inpatient Sample, the largest publicly available inpatient database in the United States. Patients 18 years and older with a primary diagnosis of AMI who underwent PCI were included in the study. The primary outcome was in-hospital mortality. Secondary outcomes included ICU admission, sepsis, septic shock, and mean cost of hospital stay. Multivariate regression analyses were performed to test for independent associations between primary and secondary outcomes with either concurrent drug (DA) or alcohol abuse (AA), or both. Procedures and diagnoses were identified using ICD-9-CM codes, and AHRQ comorbidity measures. Analysis was performed using Stata 14.2.
Results: A total of 271,315 patients with a primary diagnosis of AMI who underwent PCI were identified. A total of 8,590 patients had coexisting alcohol abuse (AA), 7,740 had coexisting drug abuse (DA), and 14,915 had both. There were no differences in mortality for patients who had either AA or DA compared to the rest of the study population. However, there was significant increase in mortality associated with having both AA and DA. In the secondary outcomes, the presence of AA, DA, or both were all associated with increased risk of ICU admission, and increased mean cost of hospital stay. Increased risk of sepsis and septic shock were associated with having both AA and DA, as well as AA alone, but not DA alone.
Conclusion: The rising prevalence of alcohol and drug abuse in the U.S. imposes significant burden on patients with AMI undergoing PCI.
Author Disclosures: S. Setareh-Shenas: None. D. Pan: None. S. Lee: None. N. Ishak Gabra: None. F. Thomas: None. E. Herzog: None.
- © 2017 by American Heart Association, Inc.