One-year risk of opioid use disorder after index hospitalization for inflammatory bowel disease

Mishal Reja, Nitya Hajela, Michael Makar, Daniel Marino, Abhishek Bhurwal, Vinod Rustgi

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: Patients with inflammatory bowel disease are commonly prescribed opiates for pain. We sought to determine the incidence of opiate use disorder after inflammatory bowel disease (IBD) admission over a 1-year period as well as its impact on mortality and hospital resource utilization. Methods: The Nationwide Readmission Database 2016 was used to identify adult patients with a principal diagnosis of IBD who were subsequently readmitted with a primary diagnosis of opioid use disorder. The primary outcome was 1-year readmission rate for opiate use disorder. Predictors were analyzed using multivariate logistic regression. Secondary outcomes were mortality rate, length of stay, and total hospital costs and charges. Results: Among the 6340 index hospitalizations for IBD, 4.7% (6.0% Crohn’s and 2.6% ulcerative colitis) were readmitted within 1 year for opiate use disorder. Readmission hospitalizations were associated with additional mortality (0.32%) and hospital utilization (length of stay 4.80 days, mean total costs $9503, and mean total charges $38,288). Ulcerative colitis had significantly higher mortality and hospital utilization costs compared with Crohn’s disease. In multivariable analysis, odds of readmission were associated with female sex (OR 1.51, CI 1.19–1.92), private insurance (OR 0.20, CI 0.11–0.37), Charlson Comorbidity Index (OR 0.20, CI 0.11–0.37), anxiety (OR 1.65, CI 1.02–2.63), and depression (OR 2.07, CI 1.28–3.34). On stratification analysis, psychiatric comorbidities were associated with both Crohn’s and ulcerative colitis. Conclusion: Patients with IBD were often readmitted for opiate use disorder and sustained significant mortality and hospital costs. Psychiatric comorbidities, gender, and insurance status impacted the odds of readmission and represent targets for intervention.

Original languageEnglish (US)
Pages (from-to)2081-2087
Number of pages7
JournalInternational Journal of Colorectal Disease
Volume35
Issue number11
DOIs
StatePublished - Nov 1 2020

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Keywords

  • Crohn’s disease
  • Opiate use disorder
  • Ulcerative colitis

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