Unity Health Toronto and Li Ka Shing Knowledge Institute of St. Michael's Hospital, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Ontario Drug Policy Research Network, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada.
Ontario Drug Policy Research Network, 30 Bond St, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Ave, Toronto, Ontario, M4N 3M5, Canada.
Drug Alcohol Depend. 2021 Aug 1;225:108830. doi: 10.1016/j.drugalcdep.2021.108830. Epub 2021 Jun 24.
Non-fatal opioid overdoses can lead to serious complications and consequently, long-term health effects. We sought to characterize trends of hospitalizations for serious complications associated with opioid overdoses in Ontario, Canada and report health services utilization and mortality in the year following hospital discharge.
We conducted a cross-sectional study in Ontario among individuals who experienced a hospitalization for a serious complication (required intubation, rhabdomyolysis, or a brain injury) associated with an opioid overdose between 2010 and 2019. We examined inpatient characteristics at the time of hospital admission, and health services utilization and mortality rates in the year following hospital discharge.
The rate of hospitalizations for serious complications associated with opioid overdoses increased by 66.7 % from 1.8 per 100,000 population in 2010 to 3.0 per 100,000 population in 2019 in Ontario. Individuals that were discharged alive from hospital experienced high health services utilization in the following year; 71.2 % (N = 953 of 1,338) visited the emergency department (ED), 34.2 % (N = 458) were admitted to hospital, and 16.4 % (N = 219) were treated in hospital for an opioid overdose. However only a quarter of individuals (N = 332; 24.8 %) initiated on opioid agonist therapy within 90 days. Additionally, 8.0 % (N = 127) of hospitalizations resulted in death within 1 year.
This study highlights increasing rates of serious complications associated with opioid overdoses, with a high demand of health services and a high mortality rate in the following year. These findings highlight an ongoing need for support and harm reduction services to allow for early intervention and follow-up care.
非致命性阿片类药物过量可导致严重并发症，并因此导致长期健康影响。我们旨在描述加拿大安大略省与阿片类药物过量相关的严重并发症住院治疗趋势，并报告出院后一年内的卫生服务利用情况和死亡率。
我们在安大略省进行了一项横断面研究，研究对象为 2010 年至 2019 年期间因阿片类药物过量导致严重并发症（需要插管、横纹肌溶解或脑损伤）而住院的个体。我们检查了入院时的住院特征，以及出院后一年内的卫生服务利用情况和死亡率。
安大略省与阿片类药物过量相关的严重并发症住院率从 2010 年的每 10 万人 1.8 例增加到 2019 年的每 10 万人 3.0 例，增加了 66.7%。从医院存活出院的患者在随后的一年中经历了高卫生服务利用率；71.2%（1338 例中有 953 例）到急诊室就诊，34.2%（458 例）住院，16.4%（219 例）因阿片类药物过量在医院接受治疗。然而，只有四分之一的患者（N=332；24.8%）在 90 天内开始接受阿片类激动剂治疗。此外，1 年内有 8.0%（N=127）的住院治疗导致死亡。
本研究强调了与阿片类药物过量相关的严重并发症发生率不断上升，随后一年对卫生服务的需求很高，死亡率也很高。这些发现突出表明，需要持续提供支持和减少伤害服务，以实现早期干预和后续护理。
