Impact of Intravenous Drug Use on Neck Abscess Outcomes: 30-Day Readmission & 5-Year Survival Rates

OBJECTIVES: Injection drug use (IDU) is a known risk factor for neck abscesses, often requiring urgent surgical intervention by acute-care Otolaryngologists. However, data on the prevalence and long-term outcomes of IDU-related neck abscesses are limited. This study investigates differences in 30-day readmission rates and 5-year all-cause mortality between patients with and without a history of IDU hospitalized for neck abscesses. METHODS: This is a retrospective cohort study utilizing the TriNetX national clinical database. Patients hospitalized for neck abscesses (ICD-10: L02.11) were categorized into two cohorts: IDU (current/previous) and non-IDU. Demographics, 30-day readmission rates, and 5-year survival were analyzed. 1:1 Propensity score matching (PSM) was used to adjust for 15 covariates known to be associated with IDU-related neck abscesses, and a two-sample t-test was applied. Kaplan-Meier analysis was performed to assess 5-year survival. RESULTS: In a cohort of 32,655 patients (mean age: 54.7, 58.4 % female), PSM resulted in 2410 patients per cohort. IDU patients had higher 30-day readmission rates than controls (10.2 % vs 7.81 %; OR: 1.32; 95 % CI: 1.10-1.62; p = 0.0061) and lower 5-year survival (77.2 % vs 81.8 %; HR: 1.21). CONCLUSION: Patients admitted for IDU-related neck abscesses have significantly higher 30-day readmission rates and decreased 5-year survival compared to non-IDU patients. These findings underscore the critical need for early detection and intervention by Otolaryngologists in this vulnerable population.