Inpatient Opioid Use Disorder and Social Determinants of Health: A Nationwide Analysis of the National Inpatient Sample (2012-2014 and 2016-2017)

Sulley, Saanie; Ndanga, Memory

doi:10.7759/cureus.11311

Cited by 14 publications

(14 citation statements)

References 28 publications

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“…Intoxicated patients also demanded greater hospital resources to facilitate care. Opioid‐intoxicated patients had greater odds of a prolonged LoS, which in the absence of more severe injury, may reflect required complex discharge planning, as well as challenges in managing acute pain in this population 21,22 . Despite no difference in ISS, we observed an increase in odds of requiring ICU admission among all intoxication groups, consistent with previously published literature 23–25 .…”

Section: Discussionsupporting

confidence: 86%

Drug and alcohol intoxication in major trauma: Associations, trends and outcomes over a decade

Woliansky

Gumm

Clark

et al. 2023

Emerg Medicine Australasia

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ObjectivesDrug and alcohol intoxication is common among injured patients altering trauma presentation and characteristics. However, uncertainty exists regarding the effect of intoxication on injury severity, as well as outcomes. The present study aims to provide an update on substance‐use patterns and their association with traumatic presentation and outcome within a contemporary Australian context.MethodsAll major trauma patients captured in our centre's Trauma Registry between July 2010 and June 2020 were included. Demographic, injury characteristic, outcome and substance‐use data were collected. Differences in injury severity and characteristics were explored using χ2 tests, while outcomes were modelled using adjusted binomial logistic regression.ResultsAmong 9700 patients, 9% were drug‐intoxicated prior to injury, while 9.4% were alcohol‐intoxicated. Drug use almost tripled between 2010 (4.8%) and 2020 (13.3%), while alcohol intoxication fell, from 11.7% to 7.3%, over the same period. Although there were significant differences in trauma mechanism among intoxicated patients, group comparison found no difference in Injury Severity Score for any group. Regarding outcomes, all intoxication resulted in significantly greater odds (odds ratio 1.62–2.41) of ICU admission. No difference in mortality was found among individual substance‐use groups; however, polysubstance‐intoxicated patients had 3.52 times greater odds of dying (95% confidence interval 1.21–10.23) compared to non‐intoxicated patients.ConclusionWithin this contemporary Australian population, we demonstrate escalating rates of drug intoxication and declining rates of alcohol intoxication prior to trauma. Intoxication was associated with more frequent violent and non‐accidental injury, and despite no difference in severity, it was associated with worse outcomes.

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Section: Discussionsupporting

confidence: 86%

Drug and alcohol intoxication in major trauma: Associations, trends and outcomes over a decade

Woliansky

Gumm

Clark

et al. 2023

Emerg Medicine Australasia

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“…The rate of presentation, as shown in this study, is about 1,205 per 100,000 births annually. High presentation rates were associated with socioeconomic and demographic indicators as shown by other studies [ 11 , 19 ].…”

Section: Discussionsupporting

confidence: 63%

Trend Analysis of Substance Use Disorder During Pregnancy

Ndanga¹,

Sulley²,

Saka³

2022

Cureus

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Objectives: This study aims to analyze the trends in substance use among pregnant women in the United States. Methodology: In this retrospective study, we utilized the National Inpatient Sample (NIS) dataset sponsored by the Agency for Healthcare Research and Quality (AHRQ) under the Healthcare Cost and Utilization Project (HCUP). Major Diagnostic Category (MDC) 14 (Pregnancy, Childbirth, and the Puerperium) and International Classification of Disease (ICD 10) codes were used to identify pregnancy-related diagnoses and presentations with any of the substance use disorder (SUD) indicators that met the inclusion criteria among the birthing population in the NIS dataset (2016-2018). We analyzed the demographic and regional characteristics between 2015 and 2018. Results: Among the population, a total of 23,475 (2.7%) had a primary or secondary diagnosis of SUD, and 851,428 (97.3%) did not. In the study group of 332,275 (2.8%) that met the inclusion criteria, 12,750 (0.1%) use alcohol, 108,960 (0.9%) had opioid use disorder (OUD), 171,490 (1.4%) use cannabis, 6,375 (0.1%) use sedatives, 28,075 (0.2%) use cocaine, 48,765 (0.4%) use other stimulants, 1,155 (0%) use hallucinogens, 115 (0%) use inhalants, and 23,950 (0.2%) had other psychoactive diagnosis. Further analysis comparing the risk of severity and mortality at presentation, procedure type, delivery method, and cost of care shows statistically significant differences (p < 0.005) between the study and control groups. Conclusion: The current trends necessitate a further assessment and implementation of comprehensive community-based treatment programs tailored to the most frequent regional SUD presentations, which could aid in mitigating drug use during pregnancy.

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“…Studies have found associations between unemployment, homelessness, drug use, and poor mental health in diverse communities. Family relationships and support are also important to consider as adolescents and young adults are likely to be influenced by behaviors they observe or perceive as acceptable based on childhood experiences (82). Interestingly, it has been proposed that internet access, dependent on place of residence, is another important SDOH to consider (81).…”

Section: Discussion Real World Importance Of Sdoh Datamentioning

confidence: 99%

Social determinants of health derived from people with opioid use disorder: Improving data collection, integration and use with cross-domain collaboration and reproducible, data-centric, notebook-style workflows

Markatou

Kennedy²,

Brachmann³

et al. 2023

Front. Med.

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Deriving social determinants of health from underserved populations is an important step in the process of improving the well-being of these populations and in driving policy improvements to facilitate positive change in health outcomes. Collection, integration, and effective use of clinical data for this purpose presents a variety of specific challenges. We assert that combining expertise from three distinct domains, specifically, medical, statistical, and computer and data science can be applied along with provenance-aware, self-documenting workflow tools. This combination permits data integration and facilitates the creation of reproducible workflows and usable (reproducible) results from the sensitive and disparate sources of clinical data that exist for underserved populations.

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Inpatient Opioid Use Disorder and Social Determinants of Health: A Nationwide Analysis of the National Inpatient Sample (2012-2014 and 2016-2017)

Cited by 14 publications

References 28 publications

Drug and alcohol intoxication in major trauma: Associations, trends and outcomes over a decade

Drug and alcohol intoxication in major trauma: Associations, trends and outcomes over a decade

Trend Analysis of Substance Use Disorder During Pregnancy

Social determinants of health derived from people with opioid use disorder: Improving data collection, integration and use with cross-domain collaboration and reproducible, data-centric, notebook-style workflows

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