In patients hospitalized for acute myocardial infarction, opioid use disorder was not significantly associated with in-hospital mortality (AOR 1.06) but was linked to increased odds of 30-day readmission (AOR 1.34).
Observational (n=3,318,257)
Yes
Does opioid use disorder affect clinical outcomes, resource utilization, and readmission rates in adults hospitalized for acute myocardial infarction?
In patients hospitalized for acute myocardial infarction, concomitant opioid use disorder is associated with similar in-hospital mortality but significantly higher resource utilization and 30-day readmission rates.
Effect estimate: AOR 1.06 (95% CI 0.99-1.13)
Absolute Event Rate: 8.6% vs 8.6%
p-value: p=0.06
OBJECTIVE: While Opioid Use Disorder (OUD) has been linked to inferior clinical outcomes, studies examining the clinical outcomes and readmission of OUD patients experiencing Acute Myocardial Infarction (AMI) remain lacking. The authors analyze the clinical and financial outcomes of OUD in a contemporary cohort of AMI hospitalizations. METHODS: All non-elective adult (≥ 18 years) hospitalizations for AMI were tabulated from the 2016‒2019 Nationwide Readmissions Database using relevant International Classification of Disease codes. Patients were grouped into OUD and non-OUD cohorts. Bivariate and regression analyses were performed to identify the independent association of OUD with outcomes after non-elective admission for AMI, as well as subsequent readmission. RESULTS: Of an estimated 3,318,257 hospitalizations for AMI meeting study criteria, 36,057 (1.1%) had a concomitant diagnosis of OUD. While OUD was not significantly associated with mortality, OUD patients experienced superior cardiovascular outcomes compared to non-OUD. However, OUD was linked to increased odds of non-cardiovascular complications, length of stay, costs, non-home discharge, and 30-day non-elective readmission. CONCLUSIONS: Patients with OUD presented with AMI at a significantly younger age than non-OUD. While OUD appears to have a cardioprotective effect, it is associated with several markers of increased resource use, including readmission. The present findings underscore the need for a multifaceted approach to increasing social services and treatment for OUD at index hospitalization.
Ascandar et al. (2023) conducted an observational in Acute Myocardial Infarction (n=3,318,257). Opioid Use Disorder vs. Non-Opioid Use Disorder was evaluated on In-hospital mortality (AOR 1.06, 95% CI 0.99-1.13, p=0.06). In patients hospitalized for acute myocardial infarction, opioid use disorder was not significantly associated with in-hospital mortality (AOR 1.06) but was linked to increased odds of 30-day readmission (AOR 1.34).