Impact of intravenous drug use on neck abscess outcomes: 30-day readmission & 5-year survival rates

ElsevierVolume 47, Issue 1, January–February 2026, 104754American Journal of OtolaryngologyAuthor links open overlay panel, , , , , AbstractObjectives

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.

Keywords

Intravenous drug use

Injection drug use

People who inject drugs

Neck abscess

Hospital readmission rates

© 2025 Published by Elsevier Inc.

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