Opioid use disorder's impact on asthma hospitalizations

IF 5.8 2区医学 Q1 ALLERGY

Annals of Allergy Asthma & Immunology Pub Date : 2025-01-01 DOI:10.1016/j.anai.2024.10.018

Francisco J. Gallegos-Koyner MD , Franc Hodo MD , Nelson I. Barrera MD , Roberto C. Cerrud-Rodriguez MD, MS , Theresa Henson MD , Lisa N. Glass MD, PhD , David H. Chong MD

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引用次数: 0

Abstract

Background

Patients with asthma and opioid use disorder (OUD) experience higher rates of acute exacerbation, but the effects of OUD on asthma hospitalizations have been poorly described.

Objective

To explore how concurrent OUD may affect the clinical outcomes of adult patients hospitalized for asthma.

Methods

Using the National Inpatient Sample, adult patients admitted for asthma with concomitant OUD were identified and compared with those without OUD. Cohorts were matched in a 1:1 ratio using propensity score matching, with mortality as primary outcome of interest.

Results

A total of 491,990 patients were hospitalized for asthma, and 3.49% had a concomitant diagnosis of OUD. Patients with asthma and OUD were younger, with a mean age of 41 years (SD ± 12.2) vs 51 years (SD ± 17.2) in those without OUD. After matching, both cohorts had 17,125 patients. There was no significant difference regarding in-hospital mortality (odds ratio [OR] 0.92, 95% CI 0.51-1.63, P = .77) between the cohorts. Patients with asthma with OUD had significantly higher rates of mechanical ventilation (OR 1.52, 95% CI 1.23-1.87, P < .001), noninvasive mechanical ventilation (OR 1.37, 95% CI 1.15-1.62, P < .001), and mean length of stay (3.18 vs 2.92 days, P < .001) compared with patients with asthma without OUD. Patients with OUD had no difference in mean total hospitalization costs ($33,514 vs $31,529, P = .054) compared with patients without OUD. Compared with a routine hospital discharge, patients with OUD were more likely to leave against medical advice (relative risk [RR] 2.67, 95% CI 2.28-3.13, P < .001), be discharged to a long-term facility (RR 1.40, 95% CI 1.01-1.95, P = .045), and be discharged with home health care (RR 1.56, 95% CI 1.22-1.99, P < .001) than patients without OUD.

Conclusion

Concomitant OUD has no impact on mortality in asthma hospitalizations, but patients with asthma with OUD have worse secondary outcomes compared with those without OUD.

查看原文本刊更多论文

阿片类药物使用障碍对哮喘住院治疗的影响：倾向匹配全国性研究》。

背景：哮喘合并阿片类药物使用障碍（OUD）患者的急性加重率较高，但OUD对哮喘住院治疗的影响却鲜有描述：探讨并发 OUD 如何影响因哮喘住院的成年患者的临床结果：方法：利用全国住院病人抽样调查，确定因哮喘住院且同时患有 OUD 的成年病人，并与未患有 OUD 的病人进行比较。采用倾向得分匹配法，以死亡率为主要研究结果，按 1:1 的比例对组群进行匹配：共有 491,990 名患者因哮喘住院，其中 3.49% 的患者同时被诊断为 OUD。哮喘合并 OUD 患者更年轻，平均年龄为 41 岁（SD±12.2），而非 OUD 患者的平均年龄为 51 岁（SD±17.2）。经过配对后，两组共有17125名患者。两组患者的院内死亡率无明显差异（OR 0.92，95% CI 0.51-1.63，P=0.77）。合并 OUD 的哮喘患者使用机械通气的比例明显更高（OR 1.52，95% CI 1.23-1.87，p）：合并 OUD 对哮喘住院患者的死亡率没有影响，但与无 OUD 的哮喘患者相比，合并 OUD 的哮喘患者的次要结果更差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Allergy Asthma & Immunology 医学-过敏

CiteScore

6.50

自引率

6.80%

发文量

437

审稿时长

33 days

期刊介绍： Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.