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Socioeconomic Burden of Rising Methamphetamine-Associated Heart Failure Hospitalizations in California From 2008 to 2018
Circulation: Cardiovascular Quality and Outcomes ( IF 6.9 ) Pub Date : 2021-07-13 , DOI: 10.1161/circoutcomes.120.007638
Susan X Zhao 1 , Andres Deluna 1 , Kate Kelsey 2 , Clifford Wang 3 , Aravind Swaminathan 1 , Allison Staniec 4 , Michael H Crawford 5
Affiliation  

Background:Methamphetamine-associated cardiomyopathy/heart failure (MethHF) is an increasingly recognized disease entity in the context of a rising methamphetamine (meth) epidemic that most severely impacts the western United States. Using heart failure (HF) hospitalization data from the Office of Statewide Health Planning and Development, this study aimed to assess trend and disease burden of MethHF in California.Methods:Adult patients (≥18 years old) with HF as primary hospitalization diagnosis between 2008 and 2018 were included in this study. The association with Meth (MethHF) and those without (non-MethHF) were determined by meth-related International Classification of Diseases-based secondary diagnoses. Statistical significance of trends in age-adjusted rates of hospitalization per 100 000 adults were evaluated using nonparametric analysis.Results:Between 2008 and 2018, 1 033 076 HF hospitalizations were identified: 42 565 were MethHF (4.12%) and 990 511 (95.88%) were non-MethHF. Age-adjusted MethHF hospitalizations per 100 000 increased by 585% from 4.1 in 2008 to 28.1 in 2018, while non-MethHF hospitalizations decreased by 6.0% from 342.3 in 2008 to 321.6 in 2018. The rate of MethHF hospitalization increase more than doubled that of a negative control group with urinary tract infection and meth-related secondary diagnoses (7.82-fold versus 3.48-fold, P<0.001). Annual inflation–adjusted hospitalization charges because of MethHF increased by 840% from $41.5 million in 2008 to $390.2 million in 2018, as compared with an 82% increase for all HF hospitalization from $3.503 billion to $6.376 billion. Patients with MethHF were significantly younger (49.64±10.06 versus 72.20±14.97 years old, P<0.001), predominantly male (79.1% versus 52.4%, P<0.001), with lower Charlson Comorbidity Index, yet they had longer length of stay, more hospitalizations per patient, and more procedures performed during their stays.Conclusions:MethHF hospitalizations increased sharply during the study period and contributed significantly to the HF hospitalization burden in California. This emerging HF phenotype, which engenders considerable financial and societal costs, calls for an urgent and concerted public health response to contain its spread.

中文翻译:

2008 年至 2018 年加州甲基苯丙胺相关心力衰竭住院人数上升的社会经济负担

背景:甲基苯丙胺相关的心肌病/心力衰竭 (MethHF) 是一种日益受到认可的疾病实体,因为甲基苯丙胺 (meth) 流行病对美国西部的影响最为严重。本研究使用来自全州健康规划和发展办公室的心力衰竭 (HF) 住院数据,旨在评估加利福尼亚州 MethHF 的趋势和疾病负担。 方法:2008 年间以 HF 作为主要住院诊断的成年患者(≥18 岁)和 2018 年被纳入这项研究。与 Meth (MethHF) 的关联和那些没有 (non-MethHF) 的关联由与 meth 相关的国际疾病分类确定基于二次诊断。使用非参数分析评估每 100 000 名成人年龄调整住院率趋势的统计显着性。 结果:在 2008 年至 2018 年间,确定了 1 033 076 例 HF 住院:42 565 例为 MethHF(4.12%)和 990 5818 例(995.5818%) ) 是非甲基氢氟酸。每 100 000 人年龄调整后的 MethHF 住院人数从 2008 年的 4.1 人增加到 2018 年的 28.1 人,增长了 585%,而非 MethHF 住院人数从 2008 年的 342.3 人下降到 2018 年的 321.6 人,下降了 6.0%,是 MethHF 住院率的两倍。尿路感染和甲基相关次要诊断的阴性对照组(7.82 倍 vs 3.48 倍,P<0.001)。由于 MethHF 导致的年度通货膨胀调整住院费用增加了 840%,从 2008 年的 4150 万美元增加到 2018 年的 3.902 亿美元,而所有 HF 住院费用增加了 82%,从 35.03 亿美元增加到 63.76 亿美元。MethHF 患者明显更年轻(49.64±10.06 岁 vs 72.20±14.97 岁,P <0.001),主要是男性(79.1% vs 52.4%,P<0.001),Charlson 合并症指数较低,但他们的住院时间更长,每位患者的住院次数更多,住院期间执行的手术次数更多。加利福尼亚。这种新出现的 HF 表型会产生可观的财务和社会成本,需要采取紧急和协调一致的公共卫生应对措施来遏制其传播。
更新日期:2021-07-21
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