Theme: Epidemiology & Public Health Research Year: 2025
Background:
Despite international reports of increasing hospitalization for injecting-related infection, there has been limited large-scale limited evaluation of in-hospital and post-discharge outcomes. This study aimed to characterise population-level injecting-related infection hospitalization and correlates associated with patient-directed discharge, readmission, and all-cause mortality among persons who inject drugs with hepatitis C in New South Wales, Australia between 2001–2022.
Methods:
Hepatitis C notifications in NSW (1993-2022) were linked to hospital (2001-2021), opioid agonist treatment (1985-2022), incarceration (1994-2021), and death registration (1993-2022) data. Hospitalizations among people who inject drugs with injecting-related infections were identified using validated ICD-10 code algorithms. Incidence of patient-directed discharge, readmission, and mortality were calculated, and correlates associated with each outcome assessed using extension of Cox proportional hazards model for recurrent events.
Results:
In total, 18,074 injecting-related infection hospitalizations were included among 9,045 individuals, predominantly males (64%) with average age 41 years. Incidence was 47.2 per 100 person-years and increased over time. The proportion of hospitalizations ending in patient-directed discharge was 18%, associated with stimulant use and incarceration, and less likely in those with severe disease and on opiate agonist therapy. The proportion of hospitalizations that were followed by a 30-day and 1-year readmission was 25% and 61%, respectively and had a strong association with patientdirected discharge. Mortality was 2% and 15% at 30-days and 1-year post discharge.
Conclusion:
Patient-directed discharge was common among people admitted with injecting-related infections, and post-discharge readmission and mortality was high. Person-centred models of care are necessary to address health inequity experienced by people who inject drugs.
Disclosure of Interest Statement:
The conference collaborators recognise the considerable contribution that industry partners make to professional and research activities. We also recognise the need for transparency of disclosure of potential conflicts of interest by acknowledging these relationships in publications and presentations.
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