how many times until 4 years ago does patient 32592 receive inject/infuse nec?
select count(*) from procedures_icd where procedures_icd.icd9_code = ( select d_icd_procedures.icd9_code from d_icd_procedures where d_icd_procedures.short_title = 'inject/infuse nec' ) and procedures_icd.hadm_id in ( select admissions.hadm_id from admissions where admissions.subject_id = 32592 ) and datetime(procedures_icd.charttime) <= datetime(current_time,'-4 year')