Predictors for 30-Day and 90-Day Hospital Readmission Among Patients With Opioid Use Disorder

by | Addiction

https://journals.lww.com/journaladdictionmedicine/Abstract/publishahead/Predictors_for_30_Day_and_90_Day_Hospital.99391.aspx

Comment; Buprenorphine works! We know that, now we know that it also reduces hospital re-admissions in a population with a chronic illness.

Moreno, Jessica L., PharmD; Wakeman, Sarah E., MD; Duprey, Matthew S., PharmD; Roberts, Russell J., PharmD; Jacobson, Jared S.; Devlin, John W., PharmDJournal of Addiction Medicine: January 8, 2019 – Volume Publish Ahead of Print – Issue – pdoi: 10.1097/ADM.0000000000000499Original Research: PDF Only

Objectives: To identify the incidence, characteristics, and predictors for 30 and 90-day readmission among acutely hospitalized patients with opioid use disorder (OUD).

Methods: This retrospective, cohort study evaluated consecutive adults with OUD admitted to an academic medical center over a 5-year period (10/1/11 to 9/30/16). Multivariable logistic regression was used to determine independent predictors for 30 and 90-day readmissions based on pertinent admission, hospital, and discharge variables collected via chart review and found to be different (with a P < 0.10) on univariate analysis.

Results: Among the 470 adults (mean age 43.1 ± 12.8 years, past heroin use 77.9%; admission opioid agonist therapy use [buprenorphine 22.6%; methadone 27.0%]; medical [vs surgical] admission 75.3%, floor [vs ICU] admission 93.0%, in-hospital mortality 0.9%), 85 (18.2%) and 151 (32.1%) were readmitted within 30 and 90 days, respectively. Among the 90-day readmitted patients, median time to first readmission was 26 days. Buprenorphineuse (vs no use) at index hospital admission was independently associated with reduced 30-day (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.24–0.93) and 90-day (OR 0.57, 95% CI 0.34–0.96) readmission; prior heroin (vs prescription opioid) use was associated with reduced 90-day readmission (OR 0.59, 95% CI 0.37–0.94) and length of hospital stay was associated with both greater 30-day (OR 1.02, 95% CI 1.01–1.05) and 90-day (OR 1.04, 95% CI 1.01–1.06) readmission rates.

Conclusions: Among patients with OUD taking buprenorphine at the time of hospital admission, 30-day and 90-day hospital readmission was reduced by 53% and 43%, respectively.© 2019 American Society of Addiction Medicine

Dr. Raymond Oenbrink
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