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Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study

Objective: Cocaine Use Disorder (CUD) has been associated with multiple complications and premature death. The purpose of the present study was to analyze the relationship between baseline medical comorbidity and long-term medical outcomes (i.e., hospitalization, death) in a cohort of patients prima...

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Autores principales: Sanvisens, Arantza, Hernández-Rubio, Anna, Zuluaga, Paola, Fuster, Daniel, Papaseit, Esther, Galan, Sara, Farré, Magí, Muga, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930813/
https://www.ncbi.nlm.nih.gov/pubmed/33679404
http://dx.doi.org/10.3389/fphar.2021.625610
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author Sanvisens, Arantza
Hernández-Rubio, Anna
Zuluaga, Paola
Fuster, Daniel
Papaseit, Esther
Galan, Sara
Farré, Magí
Muga, Robert
author_facet Sanvisens, Arantza
Hernández-Rubio, Anna
Zuluaga, Paola
Fuster, Daniel
Papaseit, Esther
Galan, Sara
Farré, Magí
Muga, Robert
author_sort Sanvisens, Arantza
collection PubMed
description Objective: Cocaine Use Disorder (CUD) has been associated with multiple complications and premature death. The purpose of the present study was to analyze the relationship between baseline medical comorbidity and long-term medical outcomes (i.e., hospitalization, death) in a cohort of patients primarily admitted for detoxification. In addition, we aimed to analyze cause-specific mortality. Methods: longitudinal study in CUD patients admitted for detoxification between 2001 and 2018. Substance use characteristics, laboratory parameters and medical comorbidity by VACS Index were assessed at admission. Follow-up and health-related outcomes were ascertained through visits and e-health records. Kaplan-Meier and Cox regression models were used to analyze survival and predictors of hospitalization and death. Results: 175 patients (77.7% men) were included. Age at admission was 35 years [IQR: 30–41 years], 59.4% of the patients being intranasal users, 33.5% injectors, and 7.1% smokers. Almost 23% of patients had concomitant alcohol use disorder, 39% were cannabis users and 9% opiate users. The median VACS Index score on admission was 10 points [IQR: 0–22]. After 12 years [IQR: 8.6–15 years] of follow-up there were 1,292 (80.7%) ED admissions and 308 (19.3%) hospitalizations. The incidence rate of ED admission and hospitalization was 18.6 × 100 p-y (95% CI: 15.8–21.8 × 100 p-y). Mortality rate was 1.4 × 100 p-y (95% CI: 0.9–2.0 × 100 p-y) and, baseline comorbidity predicted hospitalization and mortality: those with VACS Index >40 were 3.5 times (HR:3.52, 95% CI: 1.19–10.4) more likely to dye with respect to patients with VACS < 20. Conclusion: addiction care warrants optimal stratification of medical comorbidity to improve health outcomes and survival of CUD patients seeking treatment of the disorder.
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spelling pubmed-79308132021-03-05 Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study Sanvisens, Arantza Hernández-Rubio, Anna Zuluaga, Paola Fuster, Daniel Papaseit, Esther Galan, Sara Farré, Magí Muga, Robert Front Pharmacol Pharmacology Objective: Cocaine Use Disorder (CUD) has been associated with multiple complications and premature death. The purpose of the present study was to analyze the relationship between baseline medical comorbidity and long-term medical outcomes (i.e., hospitalization, death) in a cohort of patients primarily admitted for detoxification. In addition, we aimed to analyze cause-specific mortality. Methods: longitudinal study in CUD patients admitted for detoxification between 2001 and 2018. Substance use characteristics, laboratory parameters and medical comorbidity by VACS Index were assessed at admission. Follow-up and health-related outcomes were ascertained through visits and e-health records. Kaplan-Meier and Cox regression models were used to analyze survival and predictors of hospitalization and death. Results: 175 patients (77.7% men) were included. Age at admission was 35 years [IQR: 30–41 years], 59.4% of the patients being intranasal users, 33.5% injectors, and 7.1% smokers. Almost 23% of patients had concomitant alcohol use disorder, 39% were cannabis users and 9% opiate users. The median VACS Index score on admission was 10 points [IQR: 0–22]. After 12 years [IQR: 8.6–15 years] of follow-up there were 1,292 (80.7%) ED admissions and 308 (19.3%) hospitalizations. The incidence rate of ED admission and hospitalization was 18.6 × 100 p-y (95% CI: 15.8–21.8 × 100 p-y). Mortality rate was 1.4 × 100 p-y (95% CI: 0.9–2.0 × 100 p-y) and, baseline comorbidity predicted hospitalization and mortality: those with VACS Index >40 were 3.5 times (HR:3.52, 95% CI: 1.19–10.4) more likely to dye with respect to patients with VACS < 20. Conclusion: addiction care warrants optimal stratification of medical comorbidity to improve health outcomes and survival of CUD patients seeking treatment of the disorder. Frontiers Media S.A. 2021-02-18 /pmc/articles/PMC7930813/ /pubmed/33679404 http://dx.doi.org/10.3389/fphar.2021.625610 Text en Copyright © 2021 Sanvisens, Hernández-Rubio, Zuluaga, Fuster, Papaseit, Galan, Farré and Muga. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Sanvisens, Arantza
Hernández-Rubio, Anna
Zuluaga, Paola
Fuster, Daniel
Papaseit, Esther
Galan, Sara
Farré, Magí
Muga, Robert
Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study
title Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study
title_full Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study
title_fullStr Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study
title_full_unstemmed Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study
title_short Long-Term Outcomes of Patients With Cocaine Use Disorder: A 18-years Addiction Cohort Study
title_sort long-term outcomes of patients with cocaine use disorder: a 18-years addiction cohort study
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930813/
https://www.ncbi.nlm.nih.gov/pubmed/33679404
http://dx.doi.org/10.3389/fphar.2021.625610
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