One-year risk of opioid use disorder after index hospitalization for inflammatory bowel disease
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ORIGINAL ARTICLE
One-year risk of opioid use disorder after index hospitalization for inflammatory bowel disease Mishal Reja 1 & Nitya Hajela 1 & Michael Makar 1 & Daniel Marino 2 & Abhishek Bhurwal 3 & Vinod Rustgi 4 Accepted: 6 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Patients with inflammatory bowel disease are commonly prescribed opiates for pain. We sought to determine the incidence of opiate use disorder after inflammatory bowel disease (IBD) admission over a 1-year period as well as its impact on mortality and hospital resource utilization. Methods The Nationwide Readmission Database 2016 was used to identify adult patients with a principal diagnosis of IBD who were subsequently readmitted with a primary diagnosis of opioid use disorder. The primary outcome was 1-year readmission rate for opiate use disorder. Predictors were analyzed using multivariate logistic regression. Secondary outcomes were mortality rate, length of stay, and total hospital costs and charges. Results Among the 6340 index hospitalizations for IBD, 4.7% (6.0% Crohn’s and 2.6% ulcerative colitis) were readmitted within 1 year for opiate use disorder. Readmission hospitalizations were associated with additional mortality (0.32%) and hospital utilization (length of stay 4.80 days, mean total costs $9503, and mean total charges $38,288). Ulcerative colitis had significantly higher mortality and hospital utilization costs compared with Crohn’s disease. In multivariable analysis, odds of readmission were associated with female sex (OR 1.51, CI 1.19–1.92), private insurance (OR 0.20, CI 0.11–0.37), Charlson Comorbidity Index (OR 0.20, CI 0.11–0.37), anxiety (OR 1.65, CI 1.02–2.63), and depression (OR 2.07, CI 1.28–3.34). On stratification analysis, psychiatric comorbidities were associated with both Crohn’s and ulcerative colitis. Conclusion Patients with IBD were often readmitted for opiate use disorder and sustained significant mortality and hospital costs. Psychiatric comorbidities, gender, and insurance status impacted the odds of readmission and represent targets for intervention. Keywords Opiate use disorder . Crohn’s disease . Ulcerative colitis
Background This study was conducted at Rutgers Robert Wood Johnson School of Medicine. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00384-020-03691-y) contains supplementary material, which is available to authorized users. * Mishal Reja [email protected] 1
Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, New Brunswick, NJ 08901, USA
2
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
3
Department of Gastroenterology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
4
Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, USA
The opioid epidemic has been an ongoing public health crisis for most of the last decade and has been officially declared a p
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