D127. Hand Infection Encounters in the Emergency Department in the Presence of Concomitant Psychiatric Diagnoses

PURPOSE: Hand infections are frequently evaluated by hand surgeons in the emergency department. Medical comorbidities like diabetes, immunosuppression, and intravenous drug use increase hand infection risk. However, the impact of psychiatric comorbidities remains poorly characterized. This study explores the rates of emergency room presentations due to hand infection for patients with comorbid psychiatric diagnoses relative to the general population. METHODS: A retrospective case-control study was performed with data from Cosmos, a nationwide Epic® electronic health record database. Emergency room encounters related to hand infections from 2020-2023 were assessed for comorbid psychiatric diagnoses. Hand infection rates were compared between patients with documented psychiatric diagnoses and control patients. Statistical analysis was performed using GraphPad Prism with a significant p-value set at 0.05 and 95% confidence intervals for odds ratios calculated using the Woolf logit method. RESULTS: Analysis of 94,210,226 unique encounters (n=42,786,312 patients) revealed a significantly higher rate of hand infection presentation in those with a concurrent psychiatric diagnosis compared to those without (0.06% versus 0.01%, p<0.0001). Subgroup analysis confirmed higher rates for specific psychiatric disorders: schizophrenia and psychotic disorders (0.06%), bipolar disorder (0.8%), depressive disorders (0.05%), anxiety disorders (0.05%), and trauma and stressor-related disorders (0.05%) relative to control patients (0.01%, all p<0.0001) CONCLUSION: Patients with a comorbid psychiatric diagnosis showed a significantly higher rate of hand infection presentations in the emergency department. Understanding risk factors for hand infections is crucial for guiding practitioners in properly assessing and managing this complex issue.