TY  - JOUR
PY  - 2021//
TI  - Relation of substance use disorders to mortality, accident and emergency department attendances, and hospital admissions: a 13-year population-based cohort study in Hong Kong
JO  - Drug and alcohol dependence
A1  - Wei, Yue
A1  - Zhao, Jiaxi
A1  - Wong, Ian Ck
A1  - Wan, Eric Yf
A1  - Taylor, David McD
A1  - Blais, Joseph E.
A1  - Castle, David J.
A1  - Knott, Jonathan C.
A1  - Tse, Man Li
A1  - Chow, Anthony Ty
A1  - Chan, Esther W.
SP  - e109119
EP  - e109119
VL  - 229
IS  - Pt B
N2  - BACKGROUND: The impact of substance use disorders (SUD) in an Asian population has not been fully explored. We aimed to assess the risk of mortality, accident and emergency (A&E) department attendances, and hospital admissions associated with SUD in a population-based cohort study. <br><br>METHOD: Patients diagnosed with SUD in public A&E departments from 2004 to 2016 (N = 8,423) were identified in the Clinical Database Analysis and Reporting System of the Hong Kong Hospital Authority and 1:1 matched to patients without SUD by propensity score (N = 6,074 in each group). Relative risks of mortality, A&E attendances and hospital admissions were assessed using Cox regression and Hurdle negative binomial regression. <br><br>RESULTS: Patients with SUD had higher mortality (hazard ratio=1.43; 95% confidence interval [CI]=1.26-1.62) and more often died from poisoning or toxicity and injuries. The odds ratio (OR) for A&E attendances and all-cause hospital admissions associated with SUD were 2.80 (95% CI=2.58-3.04) and 3.54 (95% CI=3.26-3.83), respectively. The impact of SUD on the above outcomes was greatest among school-aged individuals (≤ 21 years) and decreased with age. The relative risk of mental disorder-related hospital admissions was much higher than that for infections, respiratory diseases, and cardiovascular diseases. In patients with SUD, ketamine and amphetamine use were associated with increased A&E attendances than opioid use. <br><br>CONCLUSIONS: SUD was associated with increased mortality, A&E attendances and hospital admissions, especially in school-aged individuals. Our findings suggest prioritising early treatment and preventive interventions for school-aged individuals and focusing on the management of comorbid mental disorders and the use of ketamine and amphetamine.<p />  <p>Language: en</p>
LA  - en
SN  - 0376-8716
UR  - http://dx.doi.org/10.1016/j.drugalcdep.2021.109119
ID  - ref1
ER  -