PDF(Sci-hub)
Abstract：
OBJECTIVE: To evaluate the association between psychiatric comorbidities, substance use disorders and heroin overdose-related hospitalizations (HOD). Next, to understand the demographic trend of HOD hospitalizations and comorbidities.
METHODS: Using the Nationwide Inpatient Sample (NIS), we included 27,442,808 child and adolescent hospitalizations, and 1432 inpatients (0.005%) were managed primarily for HOD. The odds ratio (OR) of the association of variables in HOD inpatients were measured using a logistic regression model.
RESULTS: Adolescents had 56 times higher odds (95% CI 43.36-73.30) for HOD-related hospitalizations compared to 4.6% children under 11 years. About three-fifth of the HOD inpatients were male, and they had 1.5-fold higher odds (95% CI 1.30-1.64) compared to 43% females in the study population. Whites were considerably higher in proportion (81%) than other race/ethnicities. A greater portion of HOD inpatients (40%) were from high-income families. Most common comorbid psychiatric disorders were mood (43.8%) and anxiety (20.4%). The prevalent comorbid substance use disorders were opioid (62.4%), tobacco (36.8%) and cannabis (28.5%) use disorders.
CONCLUSIONS: HOD-related hospitalizations were predominant in males, White and older adolescents (12-18 years). Prescription opioids are the bridge to heroin abuse, thereby increasing the vulnerability to other substance abuse. This requires more surveillance and should be explored to help reduce the heroin epidemic in children.
METHODS: Using the Nationwide Inpatient Sample (NIS), we included 27,442,808 child and adolescent hospitalizations, and 1432 inpatients (0.005%) were managed primarily for HOD. The odds ratio (OR) of the association of variables in HOD inpatients were measured using a logistic regression model.
RESULTS: Adolescents had 56 times higher odds (95% CI 43.36-73.30) for HOD-related hospitalizations compared to 4.6% children under 11 years. About three-fifth of the HOD inpatients were male, and they had 1.5-fold higher odds (95% CI 1.30-1.64) compared to 43% females in the study population. Whites were considerably higher in proportion (81%) than other race/ethnicities. A greater portion of HOD inpatients (40%) were from high-income families. Most common comorbid psychiatric disorders were mood (43.8%) and anxiety (20.4%). The prevalent comorbid substance use disorders were opioid (62.4%), tobacco (36.8%) and cannabis (28.5%) use disorders.
CONCLUSIONS: HOD-related hospitalizations were predominant in males, White and older adolescents (12-18 years). Prescription opioids are the bridge to heroin abuse, thereby increasing the vulnerability to other substance abuse. This requires more surveillance and should be explored to help reduce the heroin epidemic in children.
摘要：
目的：评估精神病合并症，物质使用障碍和海洛因过量相关的住院（HOD）。接下来,了解HOD住院和合并症的人口统计学趋势。
方法：使用全国住院患者样本（NIS），我们包括27,442,808名儿童和青少年住院，1432例住院患者(0.005%)主要接受HOD治疗。使用逻辑回归模型测量HOD住院患者变量关联的比值比（OR）。
结果：青少年与HOD相关的住院几率（95%CI43.36-73.30）高于4.6%的11岁以下儿童。大约五分之三的HOD住院病人是男性，与研究人群中43%的女性相比,她们的几率高出1.5倍(95%CI1.30-1.64).白人的比例（81％）明显高于其他种族/民族。HOD住院患者中有很大一部分（40％）来自高收入家庭。最常见的共患精神疾病是情绪（43.8％）和焦虑（20.4％）。普遍存在的共病物质使用障碍是阿片类药物(62.4%)，烟草(36.8%)和大麻(28.5%)使用障碍。
结论：与HOD相关的住院治疗在男性中占主导地位，白人和老年青少年（12-18岁）。处方阿片类药物是海洛因滥用的桥梁，从而增加了对其他药物滥用的脆弱性。这需要更多的监测，应该加以探索，以帮助减少儿童中的海洛因流行。
方法：使用全国住院患者样本（NIS），我们包括27,442,808名儿童和青少年住院，1432例住院患者(0.005%)主要接受HOD治疗。使用逻辑回归模型测量HOD住院患者变量关联的比值比（OR）。
结果：青少年与HOD相关的住院几率（95%CI43.36-73.30）高于4.6%的11岁以下儿童。大约五分之三的HOD住院病人是男性，与研究人群中43%的女性相比,她们的几率高出1.5倍(95%CI1.30-1.64).白人的比例（81％）明显高于其他种族/民族。HOD住院患者中有很大一部分（40％）来自高收入家庭。最常见的共患精神疾病是情绪（43.8％）和焦虑（20.4％）。普遍存在的共病物质使用障碍是阿片类药物(62.4%)，烟草(36.8%)和大麻(28.5%)使用障碍。
结论：与HOD相关的住院治疗在男性中占主导地位，白人和老年青少年（12-18岁）。处方阿片类药物是海洛因滥用的桥梁，从而增加了对其他药物滥用的脆弱性。这需要更多的监测，应该加以探索，以帮助减少儿童中的海洛因流行。
