Misclassification Error-Adjusted Prevalence of Injection Drug Use Among Infective Endocarditis Hospitalizations in the United States: A Serial Cross-Sectional Analysis of the 2007-2016 National Inpatient Sample

Overview

Journal Am J Epidemiol

Publisher Oxford University Press

Specialty Public Health

Date 2020 Sep 30

PMID 32997130

Citations 1

Authors

Kaitlin M McGrew

Tabitha Garwe

S Reza Jafarzadeh

Douglas A Drevets

Yan Daniel Zhao

Mary B Williams

Helene Carabin

Affiliations

Soon will be listed here.

Abstract

Administrative health databases have been used to monitor trends in infective endocarditis hospitalization related to nonprescription injection drug use (IDU) using International Classification of Diseases (ICD) code algorithms. Because no ICD code for IDU exists, drug dependence and hepatitis C virus (HCV) have been used as surrogate measures for IDU, making misclassification error (ME) a threat to the accuracy of existing estimates. In a serial cross-sectional analysis, we compared the unadjusted and ME-adjusted prevalences of IDU among 70,899 unweighted endocarditis hospitalizations in the 2007-2016 National Inpatient Sample. The unadjusted prevalence of IDU was estimated with a drug algorithm, an HCV algorithm, and a combination algorithm (drug and HCV). Bayesian latent class models were used to estimate the median IDU prevalence and 95% Bayesian credible intervals and ICD algorithm sensitivity and specificity. Sex- and age group-stratified IDU prevalences were also estimated. Compared with the misclassification-adjusted prevalence, unadjusted estimates were lower using the drug algorithm and higher using the combination algorithm. The median ME-adjusted IDU prevalence increased from 9.7% (95% Bayesian credible interval (BCI): 6.3, 14.8) in 2008 to 32.5% (95% BCI: 26.5, 38.2) in 2016. Among persons aged 18-34 years, IDU prevalence was higher in females than in males. ME adjustment in ICD-based studies of injection-related endocarditis is recommended.

Citing Articles

Five-Year Cardiovascular Outcomes after Infective Endocarditis in Patients with versus without Drug Use History.

Muncan B, Abboud A, Papamanoli A, Jacobs M, McLarty A, Skopicki H J Pers Med. 2022; 12(10).

PMID: 36294701 PMC: 9605539. DOI: 10.3390/jpm12101562.

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