Emergency Department Visits for Opioid Overdoses Among Patients with Cancer
Menée aux Etats-Unis à partir de données 2006-2015, cette étude analyse les facteurs associés à des consultations dans des services d'urgence hospitaliers pour prendre en charge une overdose d'opioïdes chez des patients atteints d'un cancer (35 339 visites)
Background : Patients with cancer may be at risk of high opioid use due to physical and psychosocial factors, although little data exists to inform providers and policymakers. Our aim is to examine overdoses from opioids leading to emergency department (ED) visits among patients with cancer in the United States. Methods : The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample (HCUP-NEDS) was queried for all adult cancer-related patient visits with a primary diagnosis of opioid overdose between 2006 and 2015. Temporal trends and baseline differences between patients with and without opioid-related ED visits were evaluated. Multivariable logistic regression analysis was utilized to identify risk factors associated with opioid overdose. All statistical tests were two-sided. Results : Between 2006 and 2015, there were a weighted total of 35,339 opioid-related ED visits among patients with cancer. During this timeframe, the incidence of opioid-related ED visits for overdose increased 2.0-fold (P<0.001). On multivariable regression (P<0.001), comorbid diagnoses of chronic pain (odds ratio [OR] 4.51; 95% confidence interval [CI], 4.13-4.93), substance use disorder (OR 3.54; 95% CI, 3.28-3.82), and mood disorder (OR 3.40; 95% CI, 3.16-3.65) were strongly associated with an opioid-related visit. Patients with head and neck cancer (odds ratio [OR] 2.04; 95% CI, 1.82-2.28) and multiple myeloma (OR 1.73; 95% CI, 1.32-2.26) were also at risk for overdose. Conclusions : Over the study period, the incidence of opioid-related ED visits in patients with cancer increased approximately two-fold. Comorbid diagnoses and primary disease site may predict risk for opioid overdose.