血管医学および外科ジャーナル

概要

The Burden of Substance Use Disorders among Hospitalized Patients with Underlying Cardiovascular or Cerebrovascular Disease in the United States

Ahmed Brgdar*, Mohamed Taha, Ahmad Awan, Richard Ogunti, John Gharbin, Mayar Hamad, Mehrotra Prafulla

The COVID-19 pandemic has aggravated the already devastating prevalence of substance use and drug-related morbidity and mortality in the United States. Our objective in this literature review is to present an overview of the occurrence of substance use and its impact on in-hospital clinical outcomes and healthcare resource utilization among patients hospitalized with the primary diagnosis of Cardio Vascular Diseases (CVD) or Cerebro Vascular Diseases (CeVD) in the United States. Consistent with the worsening substance abuse problem in the United States, our findings indicate an increasing prevalence of all commonly abused substances among hospitalized CVD/CeVD patients. However, there were considerable differences in clinical outcomes and resource utilization depending on the substance. The current evidence does not indicate an increased risk of in-hospital mortality, complications, or resource utilization among tobacco users. In contrast, patients with underlying alcohol or opioid use disorders had an increased risk of mortality, in-hospital complications such as cardiorespiratory failure, and more resource utilization. Cannabis use was also associated with increased occurrence of in-hospital complications, resource utilization, and mortality risk among CeVD patients, especially those with ischemic stroke, but not among CVD patients. While stimulants, anxiolytics, sedatives, or hypnotics remain poorly studied, there are some indications that stimulant users may incur a higher cost of hospitalization with elevated in-hospital mortality risk. Together, the current evidence indicates that the coexistence of Substance Use Disorder (SUD) with CVD/CeVD complicates the management of both and is associated with poor in-hospital outcomes and healthcare resource utilization.