Hand Infection Encounters in the Emergency Department in the Presence of Concomitant Psychiatric Diagnoses: A Nationwide Cosmos Study 

INTRODUCTION: Hand infections make up a significant proportion of patients evaluated by the hand surgeon in the emergency department. There are multiple comorbidities that increase a patient’s risk of developing a hand infection including diabetes mellitus, immunosuppression, and intravenous drug use. Despite this, there is a paucity of literature on the impact comorbid psychiatric diagnoses have on the rates of patient presentation to the emergency department for management of a hand infection. The goal of this study was to evaluate rates of patient presentation for hand infection in the presence of a comorbid psychiatric diagnosis and compare this to the general population. 

METHODS: We performed a retrospective case-control study based on data from Cosmos, a nationwide Epic® electronic health record database. All emergency room encounters related to hand infections over a three-year period from 2020-2023 were evaluated for the presence of a comorbid psychiatric diagnosis within the patient’s problem list. The rates of hand infection among the control population were then compared to rates in patients with a documented psychiatric diagnosis. Statistical analysis was performed using GraphPad Prism version 10.0.0 with a significant p-value set at 0.05 and 95% confidence intervals for odds ratios calculated using the Woolf logit method.