Ann Plast Reconstr Surg | Volume 3, Issue 1 | Research Article | Open Access
Shafiq Rahman, Pouya Mafi* and Keith Allison
Department of Plastic Surgery, James Cook University Hospital, UK
Fulltext PDFBackground: Intravenous Drug Users (IVDUs) pose significant clinical challenges within hospital medicine. Their burden on plastic surgery trauma services has not yet been reported within the literature. This study aimed to assess the impact of intra-venous drug users on a plastic surgery trauma unit within the North East of England.
Methods: This was a retrospective cohort study in which two groups of patients, IVDUs and nonIVDUs were assessed for demographic details as well as clinical outcomes. One hundred patients were selected randomly from within each group between January 2015 and December 2017. Assessment criteria included; age and sex, injury presented with, level of intervention, evidence of self discharge and compliance with follow up. Data analysis was conducted with Microsoft excel and SPSS version 24. Statistical tests consisting of Pearson chi square assessment as well as Fisher’s exact test were used to test the significance of proportional variation for the outcome measures.
Results: IVDUs necessitate a higher quantity of care than non users, with 78% admitted on to a ward setting for either surgical or other forms of intervention compared to 58% in the normal cohort (χ2; p<0.05, 95% CI). IVDUs also demonstrated a significantly higher incidence of not attending clinic follow ups with 62% (33/53) missing one or more clinic appointments out of those who were scheduled for routine follow up. This was much higher (Fisher analysis, p<0.05, 95% CI) compared with 4.6% (4/86) in the normal cohort. In addition IVDUs showed a higher propensity to selfdischarge compared to the normal population (χ2; p<0.05, 95% CI).
Conclusion: The IVDU cohort poses a great challenge for plastic surgery trauma services in comparison to a normal patient population. The authors suggest the use of more robust systems to help manage this group efficiently. Pre-planning for known clinical outcomes in this population will help limited NHS resources in plastic surgery run more efficiently.
IVDU; Plastic surgery trauma; PAT
Rahman S, Mafi P, Allison K. IntraVenous Drug Users: Challenges for a Plastic Surgery Trauma Service. Ann Plast Reconstr Surg. 2019;3(1):1024.