title: Cocaine use disorders and acute myocardial infarction, excess length of hospital stay and overexpenditure.
abstract: OBJECTIVE
  To investigate the relationship between the prevalence of cocaine use disorders and acute myocardial infarction in patients aged ≥ 18 years and to estimate the influence of cocaine use disorders on mortality, excess length of stay, and overexpenditure among hospitalized patients with acute myocardial infarction.
  
  
  METHODS
  Retrospective study of the minimum basic data set of 87 Spanish hospitals from 2008 to 2010.
  
  
  RESULTS
  Among 5 575 325 admissions reviewed, there were 24 126 patients with cocaine use disorders and 79 076 cases of acute myocardial infarction. The incidence of acute myocardial infarction among patients with cocaine use disorders increased with age and reached a peak at 55 years to 64 years (P < .0001). Multivariate analysis showed that cocaine use disorders were more prevalent among patients with acute myocardial infarction independently of age, sex, other addictive disorders, and 30 other comorbidities (odds ratio = 3.0). Among patients with acute myocardial infarction, those with cocaine use disorders did not show an increase of in-hospital death, but did show excess length of hospital stay (1.5 days) and overexpenditure (382 euros).
  
  
  CONCLUSIONS
  Cocaine use disorders are associated with acute myocardial infarction and increase the length of hospital stay and overexpenditure among acute myocardial infarction patients. Cessation of cocaine use among these patients should be one of the primary therapeutic goals after hospital discharge.
authors: Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen Macarena, Seville, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Seville, Spain. Electronic address: mgili@us.es.
authors: Miguel
authors: M
authors: Gili
authors: Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen Macarena, Seville, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Seville, Spain.
authors: Gloria
authors: G
authors: Ramírez
authors: Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Seville, Spain.
authors: Luis
authors: L
authors: Béjar
authors: Unidad de Gestión Clínica de Medicina Preventiva, Vigilancia y Promoción de la Salud, Hospital Universitario Virgen Macarena, Seville, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Seville, Spain.
authors: Julio
authors: J
authors: López
authors: Unidad de Gestión Clínica de Salud Mental, Hospital Universitario Virgen Macarena, Seville, Spain; Departamento de Psiquiatría, Universidad de Sevilla, Seville, Spain.
authors: Dolores
authors: D
authors: Franco
authors: Servicio de Documentación Clínica, Hospital Universitario Virgen Macarena, Seville, Spain.
authors: José
authors: J
authors: Sala
mesh_terms: D000328:Adult; D000367:Age Factors; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000191:economics / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced / Q000191:economics / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence
keywords: Cocaine; Cocaína; Exceso de costes; Excess length of stay; Infarto de miocardio; Myocardial infarction; Overexpenditure; Prolongación de estancias