One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose
Despite the increased availability of naloxone, death rates from opioid overdose continue to increase. The goal of this study is to determine the 1-year mortality of patients who were treated for a nonfatal opioid overdose in Massachusetts emergency departments (EDs). This was a retrospective observ...
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| Vydané v: | Annals of emergency medicine Ročník 75; číslo 1; s. 13 - 17 |
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| Hlavní autori: | , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
Elsevier Inc
01.01.2020
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| ISSN: | 0196-0644, 1097-6760, 1097-6760 |
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| Abstract | Despite the increased availability of naloxone, death rates from opioid overdose continue to increase. The goal of this study is to determine the 1-year mortality of patients who were treated for a nonfatal opioid overdose in Massachusetts emergency departments (EDs).
This was a retrospective observational study of patients from 3 linked statewide Massachusetts data sets: a master demographics list, an acute care hospital case-mix database, and death records. Patients discharged from the ED with a final diagnosis of opioid overdose were included. The primary outcome measure was death from any cause within 1 year of overdose treatment.
During the study period, 17,241 patients were treated for opioid overdose. Of the 11,557 patients who met study criteria, 635 (5.5%) died within 1 year, 130 (1.1%) died within 1 month, and 29 (0.25%) died within 2 days. Of the 635 deaths at 1 year, 130 (20.5%) occurred within 1 month and 29 (4.6%) occurred within 2 days.
The short-term and 1-year mortality of patients treated in the ED for nonfatal opioid overdose is high. The first month, and particularly the first 2 days after overdose, is the highest-risk period. Patients who survive opioid overdose should be considered high risk and receive interventions such as being offered buprenorphine, counseling, and referral to treatment before ED discharge. |
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| AbstractList | Despite the increased availability of naloxone, death rates from opioid overdose continue to increase. The goal of this study is to determine the 1-year mortality of patients who were treated for a nonfatal opioid overdose in Massachusetts emergency departments (EDs).STUDY OBJECTIVEDespite the increased availability of naloxone, death rates from opioid overdose continue to increase. The goal of this study is to determine the 1-year mortality of patients who were treated for a nonfatal opioid overdose in Massachusetts emergency departments (EDs).This was a retrospective observational study of patients from 3 linked statewide Massachusetts data sets: a master demographics list, an acute care hospital case-mix database, and death records. Patients discharged from the ED with a final diagnosis of opioid overdose were included. The primary outcome measure was death from any cause within 1 year of overdose treatment.METHODSThis was a retrospective observational study of patients from 3 linked statewide Massachusetts data sets: a master demographics list, an acute care hospital case-mix database, and death records. Patients discharged from the ED with a final diagnosis of opioid overdose were included. The primary outcome measure was death from any cause within 1 year of overdose treatment.During the study period, 17,241 patients were treated for opioid overdose. Of the 11,557 patients who met study criteria, 635 (5.5%) died within 1 year, 130 (1.1%) died within 1 month, and 29 (0.25%) died within 2 days. Of the 635 deaths at 1 year, 130 (20.5%) occurred within 1 month and 29 (4.6%) occurred within 2 days.RESULTSDuring the study period, 17,241 patients were treated for opioid overdose. Of the 11,557 patients who met study criteria, 635 (5.5%) died within 1 year, 130 (1.1%) died within 1 month, and 29 (0.25%) died within 2 days. Of the 635 deaths at 1 year, 130 (20.5%) occurred within 1 month and 29 (4.6%) occurred within 2 days.The short-term and 1-year mortality of patients treated in the ED for nonfatal opioid overdose is high. The first month, and particularly the first 2 days after overdose, is the highest-risk period. Patients who survive opioid overdose should be considered high risk and receive interventions such as being offered buprenorphine, counseling, and referral to treatment before ED discharge.CONCLUSIONThe short-term and 1-year mortality of patients treated in the ED for nonfatal opioid overdose is high. The first month, and particularly the first 2 days after overdose, is the highest-risk period. Patients who survive opioid overdose should be considered high risk and receive interventions such as being offered buprenorphine, counseling, and referral to treatment before ED discharge. Despite the increased availability of naloxone, death rates from opioid overdose continue to increase. The goal of this study is to determine the 1-year mortality of patients who were treated for a nonfatal opioid overdose in Massachusetts emergency departments (EDs). This was a retrospective observational study of patients from 3 linked statewide Massachusetts data sets: a master demographics list, an acute care hospital case-mix database, and death records. Patients discharged from the ED with a final diagnosis of opioid overdose were included. The primary outcome measure was death from any cause within 1 year of overdose treatment. During the study period, 17,241 patients were treated for opioid overdose. Of the 11,557 patients who met study criteria, 635 (5.5%) died within 1 year, 130 (1.1%) died within 1 month, and 29 (0.25%) died within 2 days. Of the 635 deaths at 1 year, 130 (20.5%) occurred within 1 month and 29 (4.6%) occurred within 2 days. The short-term and 1-year mortality of patients treated in the ED for nonfatal opioid overdose is high. The first month, and particularly the first 2 days after overdose, is the highest-risk period. Patients who survive opioid overdose should be considered high risk and receive interventions such as being offered buprenorphine, counseling, and referral to treatment before ED discharge. Study objectiveDespite the increased availability of naloxone, death rates from opioid overdose continue to increase. The goal of this study is to determine the 1-year mortality of patients who were treated for a nonfatal opioid overdose in Massachusetts emergency departments (EDs). MethodsThis was a retrospective observational study of patients from 3 linked statewide Massachusetts data sets: a master demographics list, an acute care hospital case-mix database, and death records. Patients discharged from the ED with a final diagnosis of opioid overdose were included. The primary outcome measure was death from any cause within 1 year of overdose treatment. ResultsDuring the study period, 17,241 patients were treated for opioid overdose. Of the 11,557 patients who met study criteria, 635 (5.5%) died within 1 year, 130 (1.1%) died within 1 month, and 29 (0.25%) died within 2 days. Of the 635 deaths at 1 year, 130 (20.5%) occurred within 1 month and 29 (4.6%) occurred within 2 days. ConclusionThe short-term and 1-year mortality of patients treated in the ED for nonfatal opioid overdose is high. The first month, and particularly the first 2 days after overdose, is the highest-risk period. Patients who survive opioid overdose should be considered high risk and receive interventions such as being offered buprenorphine, counseling, and referral to treatment before ED discharge. |
| Author | Schuur, Jeremiah D. Weiner, Scott G. Baker, Olesya Bernson, Dana |
| Author_xml | – sequence: 1 givenname: Scott G. orcidid: 0000-0002-4672-5184 surname: Weiner fullname: Weiner, Scott G. email: sweiner@bwh.harvard.edu organization: Brigham and Women’s Hospital, Boston, MA – sequence: 2 givenname: Olesya surname: Baker fullname: Baker, Olesya organization: Brigham and Women’s Hospital, Boston, MA – sequence: 3 givenname: Dana surname: Bernson fullname: Bernson, Dana organization: Massachusetts Department of Public Health, Boston, MA – sequence: 4 givenname: Jeremiah D. surname: Schuur fullname: Schuur, Jeremiah D. organization: Alpert Medical School, Brown University, Providence, RI |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31229387$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.15585/mmwr.mm6709e1 10.1001/jama.2015.3474 |
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| References_xml | – ident: bib4 article-title: Data brief: opioid-related overdose deaths among Massachusetts residents – volume: 67 start-page: 279 year: 2018 end-page: 285 ident: bib3 article-title: Vital signs: trends in emergency department visits for suspected opioid overdoses—United States, July 2016–September 2017 publication-title: MMWR Morb Mortal Wkly Rep – volume: 313 start-page: 1636 year: 2015 end-page: 1644 ident: bib9 article-title: Emergency department–initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial publication-title: JAMA – year: 2017 ident: bib8 article-title: Mortality in the United States, 2016 – year: 2017 ident: bib2 article-title: Annual Surveillance Report of Drug-Related Risks and Outcomes—United States, 2017 – ident: bib5 article-title: Commonwealth of Massachusetts. Massachusetts Chapter 52 of the Acts of 2016. An act relative to substance use, treatment, education and prevention – ident: bib6 article-title: 190th General Court of the Commonwealth of Massachusetts. Chapter 55: an act requiring certain reports for opiate overdoses – year: 2017 ident: bib7 article-title: An Assessment of Fatal and Nonfatal Opioid Overdoses in Massachusetts (2011-2015) – ident: bib1 article-title: CDC Wonder. Number of deaths involving opioids. Revised January 2019 – year: 2017 ident: 10.1016/j.annemergmed.2019.04.020_bib8 – volume: 67 start-page: 279 year: 2018 ident: 10.1016/j.annemergmed.2019.04.020_bib3 article-title: Vital signs: trends in emergency department visits for suspected opioid overdoses—United States, July 2016–September 2017 publication-title: MMWR Morb Mortal Wkly Rep doi: 10.15585/mmwr.mm6709e1 – volume: 313 start-page: 1636 year: 2015 ident: 10.1016/j.annemergmed.2019.04.020_bib9 article-title: Emergency department–initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial publication-title: JAMA doi: 10.1001/jama.2015.3474 – year: 2017 ident: 10.1016/j.annemergmed.2019.04.020_bib2 |
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| Snippet | Despite the increased availability of naloxone, death rates from opioid overdose continue to increase. The goal of this study is to determine the 1-year... Study objectiveDespite the increased availability of naloxone, death rates from opioid overdose continue to increase. The goal of this study is to determine... |
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| SubjectTerms | Adult Analgesics, Opioid - poisoning Databases, Factual Drug Overdose - mortality Emergency Emergency Service, Hospital - statistics & numerical data Female Humans Male Massachusetts - epidemiology Middle Aged Retrospective Studies Time Factors |
| Title | One-Year Mortality of Patients After Emergency Department Treatment for Nonfatal Opioid Overdose |
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