J.A. Singh, MBBS, MPH, Medicine Service, VA Medical Center, Birmingham, and Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama at Birmingham;
J.D. Cleveland, MS, Department of Medicine at School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Rheumatol. 2021 May;48(5):775-784. doi: 10.3899/jrheum.191370. Epub 2020 Oct 1.
To examine opioid use disorder (OUD)-related hospitalizations and associated healthcare utilization outcomes in people with 5 common musculoskeletal diseases (MSD).
We used the US National Inpatient Sample (NIS) data from 1998 to 2014 to examine the rates of OUD hospitalizations (per 100,000 NIS claims overall), time trends, and outcomes in 5 common rheumatic diseases: gout, rheumatoid arthritis (RA), fibromyalgia (FM), osteoarthritis (OA), and low back pain (LBP).
OUD hospitalization rate per 100,000 total NIS claims in 1998-2000 vs 2015-2016 (and increase) were as follows: gout, 0.05 vs 1.88 (36-fold); OA, 0.68 vs 10.22 (14-fold); FM, 0.53 vs 6.98 (12-fold); RA, 0.30 vs 3.16 (9.5-fold); and LBP, 1.17 vs 7.64 (5.5-fold). The median hospital charges and hospital stays for OUD hospitalizations were as follows: gout, $18,363 and 2.5 days; RA, $17,398 and 2.4 days; FM, $15,772 and 2.1 days; OA, $16,795 and 2.4 days; and LBP, $13,722 and 2.0 days. In-hospital mortality rates ranged from 0.9% for LBP and FM to 1.7% for gout with OUD hospitalizations. Compared to those without each MSD, age-, sex-, race-, and income-adjusted total hospital charges (inflation-adjusted) for OUD hospitalizations with each rheumatic disease were as follows: gout, $697 higher; OA, $4759 lower; FM, $2082 lower; RA, $1258 lower; and LBP, $4944 lower.
OUD hospitalizations increased in all 5 MSD studied, but the rate of increase differed. Awareness of these OUD hospitalization trends in 5 MSD among providers, policy makers, and patients is important. Development and implementation of interventions, policies, and practices to potentially reduce OUD-associated effects in people with rheumatic diseases is needed.
研究 5 种常见肌肉骨骼疾病（MSD）患者的阿片类药物使用障碍（OUD）相关住院情况及相关医疗保健利用结果。
我们使用了 1998 年至 2014 年美国国家住院患者样本（NIS）的数据，研究了 5 种常见风湿性疾病（痛风、类风湿关节炎（RA）、纤维肌痛（FM）、骨关节炎（OA）和下腰痛（LBP））的 OUD 住院率（每 10 万 NIS 索赔）、时间趋势和结果。
1998-2000 年与 2015-2016 年（增加）每 10 万 NIS 索赔的 OUD 住院率（倍数）如下：痛风，0.05 对 1.88（36 倍）；OA，0.68 对 10.22（14 倍）；FM，0.53 对 6.98（12 倍）；RA，0.30 对 3.16（9.5 倍）；LBP，1.17 对 7.64（5.5 倍）。OUD 住院的中位数住院费用和住院天数如下：痛风，18363 美元和 2.5 天；RA，17398 美元和 2.4 天；FM，15772 美元和 2.1 天；OA，16795 美元和 2.4 天；LBP，13722 美元和 2.0 天。OUD 住院的院内死亡率范围为痛风 0.9%至 FM 1.7%，LBP 1.7%。与每种 MSD 无 OUD 住院的患者相比，每种风湿性疾病 OUD 住院患者的总住院费用（经通胀调整）（经通胀调整）如下：痛风，高 697 美元；OA，低 4759 美元；FM，低 2082 美元；RA，低 1258 美元；LBP，低 4944 美元。
在所有 5 种研究的 MSD 中，OUD 住院人数均有所增加，但增加幅度不同。提供者、政策制定者和患者应了解这些在 5 种 MSD 中 OUD 住院的趋势。需要制定和实施干预措施、政策和实践，以减少风湿性疾病患者中与 OUD 相关的影响。
