title: DETERMINANTS OF CUTANEOUS INJECTION-RELATED INFECTIONS AMONG INJECTION DRUG USERS AT AN EMERGENCY DEPARTMENT.
abstract: BACKGROUND
  Cutaneous injection-related infections (CIRI) are a primary reason injection drug users (IDU) access the emergency department (ED).
  
  
  METHODS
  Using Cox proportional hazard regression, we examined predictors of ED use for CIRI, stratified by sex, among 1083 supervised injection facility (SIF) users.
  
  
  RESULTS
  Over a four-year period, 289 (27%) visited the ED for CIRI, yielding an incidence density for females of 23.8 (95% confidence interval (CI): 19.3 - 29.0) and males of 19.2 per 100 person-years (95% CI: 16.7 - 22.1). Factors associated with ED use for CIRI among females included residing in the Downtown Eastside (DTES) (adjusted hazard ratio [AHR] = 2.06 [1.13 - 3.78]) and being referred to hospital by SIF nurses (AHR = 4.48 [2.76 - 7.30]). Among males, requiring assistance with injection (AHR = 1.38 [1.01 - 1.90]), being HIV-positive (AHR = 1.85 [1.34 - 2.55]), and being referred to hospital by SIF nurses (AHR = 2.97 [1.93 - 4.57]) were associated with an increased likelihood of an ED visit for CIRI.
  
  
  CONCLUSIONS
  These results suggest SIF nurses have facilitated referral of hospital treatment for CIRI, highlighting the need for continued development of efficient and collaborative efforts to reduce the burden of CIRI.
authors: British Columbia Centre for Excellence in HIV/AIDS, Providence Health Care, 608-1081 Burrard Street, Vancouver, V6Z 1Y6, Canada ; School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, V6T 1Z3, Canada.
authors: Elisa
authors: E
authors: Lloyd-Smith
authors: Mark
authors: M
authors: Tyndall
authors: Ruth
authors: R
authors: Zhang
authors: Eric
authors: E
authors: Grafstein
authors: Sam
authors: S
authors: Sheps
authors: Evan
authors: E
authors: Wood
authors: Julio
authors: J
authors: Montaner
authors: Thomas
authors: T
authors: Kerr
keywords: abscesses; cellulitis; emergency department; epidemiology; gender; health services; injection drug use