Abstract
Introduction
The opioid epidemic has contributed significantly to the healthcare economic burden nationwide.
Methods
Using the 2016 National Readmission Database, patients were included if they had a principal diagnosis of burn injury. Opioid dependence was identified using appropriate ICD-10 CM codes. The primary outcome was 30-day all-cause readmission. Secondary outcomes were in-hospital and calendar-year mortality, resource utilization, and most common reasons for admission and readmission. Confounders were adjusted for using multivariate regression analysis.
Results
22,348 patients were included, 597 of whom were opioid dependent. Opioid dependent patients were more likely to be older (43 years, range: 38.6–47.2 years) and male (70.8%) compared with patients without opioid dependence. Opioid dependence was associated with higher 30-day readmission rates (adjusted odds ratio (aOR): 1.93, 95% confidence interval (CI):1.39–2.68, p-value: < 0.01), longer mean length of stay (adjusted mean difference (aMD): 5.46 days, CI:2.63–8.29, p-value: < 0.01). and higher total hospitalization charges (aMD: $50,050, CI:$5,941-$94,960, p-value: 0.03) and costs (aMD: $14,889, CI:$3,658-$26,119, p-value: 0.01). However, opioid dependence was associated with lower in-hospital (aOR: 0.23, CI:0.06–0.85, p-value: 0.03) and calendar-year (aOR: 0.47, CI:0.22–0.99, p-value: 0.04) mortality. The most common reasons for both initial admission and readmission are presented in Table 1.
Conclusions
Opioid dependence is associated with lower in-hospital and calendar-year mortality, but higher rates of readmission, longer mean length of stay and higher hospital charges among patients with burn injuries.
Applicability of Research to Practice
Despite increased resource utilization for patients with opioid dependence, mortality was decreased in this population. Further research is needed to elucidate this paradox.
