(0660) Impact of Intravenous Drug Use on Neck Abscess Outcomes: Readmission Rates and Implications for Otolaryngologists

Introduction: Intravenous drug use (IVDU) is a well-documented risk factor associated with neck abscesses, often requiring urgent surgical intervention by acute-care otolaryngologists. There remains a paucity of data on the prevalence and downstream burden of IVDU-related neck abscesses on both patients and the healthcare system. In patients who are hospitalized for neck abscesses, we aim to investigate differences in 30-day readmission rates in patients with versus without a history of IVDU.

Methods: We conducted a retrospective cohort review of patients hospitalized for neck abscesses (ICD10:L02.11) from January 2004 to September 2023 utilizing the TriNetX national clinical database. The database was used to create two cohorts of patients (≥ 18 years) hospitalized for neck abscesses, categorized into an IVDU cohort (ICD10:F19.10) and a control cohort (non-IVDU). Data regarding patient demographics and 30-day readmission rates were collected. A two-sample t-test was conducted after 1:1 Propensity score matching (PSM) was utilized to match for the covariates of age, sex, race, and ethnicity. Projected Kaplan-Meier survivability analyses were also conducted.

Results: The total cohort (n = 27,072) of patients hospitalized for neck abscesses had a mean age of 49.5 years old and 60% were male. After PSM, patients in the IVDU cohort (n = 1,264) had increased 30-day readmission rates compared to the control cohort (n = 25,808) (12.4% vs 7.57%; OR: 1.73; 95% CI: 1.36-2.67; p < 0.0001). Kaplan-Meier analyses demonstrated decreased 30-day survivability in the IVDU cohort when compared to controls (86.9% vs 91.3%, p < 0.0003).

Conclusions: Patients admitted for neck abscesses with a history of IVDU have significantly increased 30-day readmission rates compared to non-IVDU. This population also demonstrates decreased 30-day survivability, highlighting the profound health implications of IVDU. Among IVDU patients, the prevalence of neck abscess hospitalizations and escalating healthcare costs associated with increased 30-day readmission rates emphasizes the importance of early detection and intervention by otolaryngologists.