The Impact of the Drug Epidemic on the Incidence of Sepsis in West Virginia.

Introduction Drug abuse and overdoses are on the rise in West Virginia. Multiple socioeconomic and prescription-prescribing practices influenced this shift. The shifting burden of intravenous drug use to more rural areas has created unique challenges for patient access (medical attention, addiction education, rehabilitation), as well as created an avalanche of additional costs for hospital networks. Methods We analyzed sepsis cases from 2006 to 2015 to investigate whether different types of drug use have increased the odds of developing sepsis as compared to other forms of drug use. To investigate this aspect, the authors examined this relationship by using a logistical regression and a time series analysis of the total cases of drug use and infections. Results The initial analysis investigated the association between drug use and the number of sepsis cases at Charleston Area Medical Center from 2006 to 2015 using a time series analysis. Results suggest that there are similar relationships between sepsis and sedative usage (p=0.016) and sepsis by mixed/other drug (p= 0.020) use. For logistic regression (n=2284), the infection models of sepsis/skin, endocarditis/skin infection, and osteomyelitis/skin infection showed several exposures significantly increased the risk of different infections. A drug user with a positive urine test for opiates is 80.8 percent more likely to develop sepsis as compared to skin infections (p=0.001). The use of sedatives also significantly increased the odds of developing sepsis by 83.2 percent (p=0.002). Conclusion Sepsis left untreated will result in a high mortality rate. As illicit drug use increases, sepsis cases will increase. Further research is needed to understand the continued relationship between drug use and the incidence of sepsis. Based on the current evidence, sepsis appears to be slightly affected by drug use and seems to be influenced by sedatives and opiates but only at a marginal level.