AUTHORS: Burton, Brittany N., MHS, MAS et al
METHODS: Using the 2010–2014 Nationwide Inpatient Sample, we performed a cross-sectional analysis and identified a weighted estimate of 570,987 adult patients with an International Classification of Disease, Ninth Revision, or External Cause of Injury code of POD or IOD. We performed multivariable logistic regression to identify predictors of inpatient mortality. The odds ratio (OR) and their associated 95% confidence interval (CI) are reported.
RESULTS: Of the 570,987 patients with opioid overdose, 13.8% had an admissions diagnosis of IOD, and the remaining had POD. Among all opioid overdose admissions, the adjusted odds of IOD admissions increased by 31% per year (OR, 1.31; 95% CI, 1.29–1.31; P < .001); however, the adjusted odds POD admissions decreased by 24% per year (OR, 0.76; 95% CI, 0.75–0.77; P < .001). The mortality was 4.7% and 2.3% among IOD and POD admissions, respectively. The odds of inpatient mortality increased by 8% per year among IOD admissions (OR, 1.08; 95% CI, 1.02–1.14; P < .007). The odds of inpatient mortality increased by 6% per year among all POD admissions (OR, 1.06; 95% CI, 1.03–1.09; P < .001). Those with IOD compared to POD had higher odds of mortality (OR, 2.03; 95% CI, 1.79–2.29; P < .001). Patients with age ≥80 years of age and those with a diagnosis of a solid tumor malignancy had higher odds of mortality. Odds of inpatient mortality were decreased in African American versus Caucasian patients and in patients undergoing alcohol rehabilitation therapy.
CONCLUSIONS: The increase in mortality provides a strong basis for further risk reduction strategies and intervention program implementation. Medical management of not only the opioid overdose but also the comorbidities calls for a multidisciplinary approach that involves policy makers and health care teams.
KEY POINTS
- Question: What are the factors associated with inpatient mortality in patients admitted to the hospital for opioid overdose?
- Findings: Illicit opioid overdose, older age, and solid tumor malignancy were associated with increased odds of inpatient mortality, whereas African American race and drug/alcohol rehabilitation were associated with decreased odds of inpatient mortality.
- Meaning: Targeted program implementation and risk reduction strategies are urgently needed.
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