Chart-documented Illicit Drug Use Has Implications in Sepsis and Associates with Acute Kidney Injury
Sepsis, a systemic inflammatory state due to a dysregulated response to infection, is one of the most common reasons for ICU admission. For instance, sepsis serves as the leading cause of death in hospitalized patients, and is responsible for 220,000 deaths annually. Sepsis commonly associates with other related outcomes, with a third of sepsis patients developing Acute Kidney Injury (AKI). Limited research investigates the influence of illicit drug use on sepsis characteristics and sepsis-associated outcomes. In this research, I aim to describe the associations between illicit drug use, patient characteristics, and sepsis-related outcomes. Additionally, I aim to determine whether illicit drug use is independently associated with AKI incidence or 30-day mortality. Our study population includes patients enrolled in the molecular epidemiology of severe sepsis in the ICU (MESSI) cohort during the years of 2015 to 2020. Statistical analyses were utilized to investigate these associations, and conclusions were drawn. In summary, our investigation revealed that illicit drug use is independently associated with AKI development following model adjustments. Despite being younger on average, illicit drug users had similar 30-day mortality and length of hospital stay compared to their older, non-illicit drug user counterparts.
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Chart-documented Illicit Drug Use
Excellent presentation, Kirstin! On your poster you note that future research should investigate differences in drug types and sepsis outcomes and “the biologic mechanisms underlying these associations.” That seems undoubtedly a great vein for additional investigation. I note also, though, that you acknowledge that some potentially important variables, such as socioeconomic factors, were not captured. That got me wondering if having chart-documented illicit drug use might actually lead to other changes in patient treatment (perhaps due to bias in the health care team, or inability to follow-through with more effective/expensive treatments) that could lead to more severe/negative outcomes such as AKI in these patients? Assuming you’re interested in that question, would there even be a way to study that?