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.
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.
Authors: Ateka Gunja; Maggie A Stanislawski; Anna E Barón; Thomas M Maddox; Steven M Bradley; Mladen I Vidovich Journal: Clin Cardiol Date: 2018-06-09 Impact factor: 2.882
Authors: K D Oliveira; G P Fraga; E C E Baracat; A M Morcillo; R Lanaro; J L Costa; E M Capitani; F Bucaretchi; A I Ferreira Filho; V C Gimenes; R C S de Azevedo Journal: Eur J Trauma Emerg Surg Date: 2017-11-07 Impact factor: 3.693
Authors: Farhad Sami; Wan-Chi Chan; Prakash Acharya; Prince Sethi; Chad Cannon; Eric S Hockstad; Peter N Tadros; Mark A Wiley; Kamal Gupta Journal: J Am Coll Emerg Physicians Open Date: 2022-01-15
Authors: Shantanu Solanki; Raja Chandra Chakinala; Khwaja Fahad Haq; Muhammad Ali Khan; Alina Kifayat; Katherine Linder; Zubair Khan; Uvesh Mansuri; Khwaja Saad Haq; Christopher Nabors; Wilbert S Aronow Journal: Ann Transl Med Date: 2019-12