Abstract: FR-PO901

Opioid Overdose Hospitalizations with Patients with ESRD – Nationwide Trends and Outcomes

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Sakhuja, Swati, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Sakhuja, Ankit, Mayo Clinic, Rochester, Minnesota, United States
  • Banaei-Kashani, Kianoush, Mayo Clinic, Rochester, Minnesota, United States
Background

Opioid overdose is responsible for more deaths than firearms or motor vehicle crashes in the United States. Recent studies have shown opioid use to be widely prevalent in end stage renal disease (ESRD) patients, however, epidemiology and outcomes of opioid overdose in this population are unclear.

Methods

Using data from National/Natiowide Inpatient Sample database from year 2000-2013, we identified patients 20 years or older with opioid overdose admissions and those with ESRD using ICD-9-CM codes. Using data from US Census and USRDS render, we assessed the trend of incidence of opioid overdoses in ESRD and general population. We also examined the associated mortality and if ESRD is an independent predictor of mortality in these patients in a model adjusted for age, sex, race, primary payer, Charlson’s score, hospital bed size, volume, region, location & teaching status, use of mechanical ventilation, classification of poisoning as suicidal, homicidal, accidental or unknown and year of admission.

Results

Of total 558,737 opioid overdose admissions, 7496 (1.3%) had ESRD. The incidence of opioid overdose (per 100,000 population) increased from 92 to 183 in ESRD and 19 to 31 in general population (Fig 1). Patients with ESRD were more often in 45-79 yr age-group, blacks or Hispanic and with higher co-morbidities. Inpatient mortality was higher in patients with ESRD (4.0% vs 2.5%; p<0.001). In addition, having ESRD was an independent predictor for mortality in these patients (OR 1.42; 95% CI 1.02-1.98).

Conclusion

The incidence of opioid overdose is higher in ESRD patients and is rising at a rapid pace. ESRD patients with overdose have higher mortality and ESRD is an independent predictor for mortality in patients with opioid overdose.

Fig 1: Trends of incidence of opioid overdose in ESRD and general population