Abstract
Background: The outcomes related to chest pain associated with cocaine use and its burden on the healthcare system are not well studied. Methods: Data were collected from the Nationwide Inpatient Sample (2001-2012). Subjects were identified by using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Primary outcome was a composite of mortality, myocardial infarction, stroke, and cardiac arrest. Results: We identified 363,143 admissions for cocaine-induced chest pain. Mean age was 44.9 (±21.1) years with male predominance. Left heart catheterizations were performed in 6.7%, whereas the frequency of acute myocardial infarction and percutaneous coronary interventions were 0.69% and 0.22%, respectively. The in-hospital mortality was 0.09%, and the primary outcome occurred in 1.19% of patients. Statistically significant predictors of primary outcome included female sex (odds ratio [OR], 1.16; confidence interval [CI], 1.00-1.35; P = .046), age >50 years (OR, 1.24, CI, 1.07-1.43; P = .004), history of heart failure (OR, 1.63, CI, 1.37-1.93; P <.001), supraventricular tachycardia (OR, 2.94, CI, 1.34-6.42; P = .007), endocarditis (OR, 3.5, CI, 1.50-8.18, P = .004), tobacco use (OR, 1.3, CI, 1.13-1.49; P <.001), dyslipidemia (OR, 1.5, CI, 1.29-1.77; P <.001), coronary artery disease (OR, 2.37, CI, 2.03-2.76; P <.001), and renal failure (OR, 1.27, CI, 1.08-1.50; P = .005). The total annual projected economic burden ranged from $155 to $226 million with a cumulative accruement of more than $2 billion over a decade. Conclusion: Hospital admissions due to chest pain and concomitant cocaine use are associated with low rates of adverse outcomes. For the low-risk cohort in whom acute coronary syndrome has been ruled out, hospitalization may not be beneficial and may result in unnecessary cardiac procedures.
| Original language | English (US) |
|---|---|
| Journal | American Journal of Medicine |
| DOIs | |
| State | Accepted/In press - 2017 |
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Keywords
- Chest pain
- Cocaine use
- Mortality
- Myocardial infarction
- Percutaneous coronary intervention
ASJC Scopus subject areas
- Medicine(all)
Cite this
Hospital Admissions for Chest Pain Associated with Cocaine Use in the United States. / Singh, Vikas; Rodriguez, Alex P.; Thakkar, Badal; Savani, Ghanshyambhai T.; Patel, Nileshkumar J.; Badheka, Apurva O.; Cohen, Mauricio G; Alfonso, Carlos E; Mitrani, Raul; Viles Gonzalez, Juan; Goldberger, Jeffrey.
In: American Journal of Medicine, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hospital Admissions for Chest Pain Associated with Cocaine Use in the United States
AU - Singh, Vikas
AU - Rodriguez, Alex P.
AU - Thakkar, Badal
AU - Savani, Ghanshyambhai T.
AU - Patel, Nileshkumar J.
AU - Badheka, Apurva O.
AU - Cohen, Mauricio G
AU - Alfonso, Carlos E
AU - Mitrani, Raul
AU - Viles Gonzalez, Juan
AU - Goldberger, Jeffrey
PY - 2017
Y1 - 2017
N2 - Background: The outcomes related to chest pain associated with cocaine use and its burden on the healthcare system are not well studied. Methods: Data were collected from the Nationwide Inpatient Sample (2001-2012). Subjects were identified by using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Primary outcome was a composite of mortality, myocardial infarction, stroke, and cardiac arrest. Results: We identified 363,143 admissions for cocaine-induced chest pain. Mean age was 44.9 (±21.1) years with male predominance. Left heart catheterizations were performed in 6.7%, whereas the frequency of acute myocardial infarction and percutaneous coronary interventions were 0.69% and 0.22%, respectively. The in-hospital mortality was 0.09%, and the primary outcome occurred in 1.19% of patients. Statistically significant predictors of primary outcome included female sex (odds ratio [OR], 1.16; confidence interval [CI], 1.00-1.35; P = .046), age >50 years (OR, 1.24, CI, 1.07-1.43; P = .004), history of heart failure (OR, 1.63, CI, 1.37-1.93; P <.001), supraventricular tachycardia (OR, 2.94, CI, 1.34-6.42; P = .007), endocarditis (OR, 3.5, CI, 1.50-8.18, P = .004), tobacco use (OR, 1.3, CI, 1.13-1.49; P <.001), dyslipidemia (OR, 1.5, CI, 1.29-1.77; P <.001), coronary artery disease (OR, 2.37, CI, 2.03-2.76; P <.001), and renal failure (OR, 1.27, CI, 1.08-1.50; P = .005). The total annual projected economic burden ranged from $155 to $226 million with a cumulative accruement of more than $2 billion over a decade. Conclusion: Hospital admissions due to chest pain and concomitant cocaine use are associated with low rates of adverse outcomes. For the low-risk cohort in whom acute coronary syndrome has been ruled out, hospitalization may not be beneficial and may result in unnecessary cardiac procedures.
AB - Background: The outcomes related to chest pain associated with cocaine use and its burden on the healthcare system are not well studied. Methods: Data were collected from the Nationwide Inpatient Sample (2001-2012). Subjects were identified by using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Primary outcome was a composite of mortality, myocardial infarction, stroke, and cardiac arrest. Results: We identified 363,143 admissions for cocaine-induced chest pain. Mean age was 44.9 (±21.1) years with male predominance. Left heart catheterizations were performed in 6.7%, whereas the frequency of acute myocardial infarction and percutaneous coronary interventions were 0.69% and 0.22%, respectively. The in-hospital mortality was 0.09%, and the primary outcome occurred in 1.19% of patients. Statistically significant predictors of primary outcome included female sex (odds ratio [OR], 1.16; confidence interval [CI], 1.00-1.35; P = .046), age >50 years (OR, 1.24, CI, 1.07-1.43; P = .004), history of heart failure (OR, 1.63, CI, 1.37-1.93; P <.001), supraventricular tachycardia (OR, 2.94, CI, 1.34-6.42; P = .007), endocarditis (OR, 3.5, CI, 1.50-8.18, P = .004), tobacco use (OR, 1.3, CI, 1.13-1.49; P <.001), dyslipidemia (OR, 1.5, CI, 1.29-1.77; P <.001), coronary artery disease (OR, 2.37, CI, 2.03-2.76; P <.001), and renal failure (OR, 1.27, CI, 1.08-1.50; P = .005). The total annual projected economic burden ranged from $155 to $226 million with a cumulative accruement of more than $2 billion over a decade. Conclusion: Hospital admissions due to chest pain and concomitant cocaine use are associated with low rates of adverse outcomes. For the low-risk cohort in whom acute coronary syndrome has been ruled out, hospitalization may not be beneficial and may result in unnecessary cardiac procedures.
KW - Chest pain
KW - Cocaine use
KW - Mortality
KW - Myocardial infarction
KW - Percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=85013104738&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85013104738&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2016.12.003
DO - 10.1016/j.amjmed.2016.12.003
M3 - Article
C2 - 28063854
AN - SCOPUS:85013104738
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
ER -