The impact of obesity in patients hospitalized with opioid/opiate overdose.

: Although a direct link between opioid use in obese patients and risk of overdose has not been established, obesity is highly associated with higher risk for opioid/opiate overdose. Evidence for clinical impact of obesity on patients with opioid/opiate overdose is scarce. The aim of this study was to determine effects of obesity on health-care outcomes and mortality trends in hospitalized patients who presented with opioid/opiate overdose in the United States between 2010 and 2014. Multivariate logistic and linear regression analysis compared clinical outcomes and hospital resource utilization between obese and nonobese patients. Trend analysis of in-hospital mortality was also analyzed. United States. 302,863 adults ≥ 18 years and hospitalized with a principle diagnosis of opioid/opiate overdoses between 2010 and 2014. Primary measurement was in-hospital mortality. Secondary measurements included respiratory failure, cardiogenic shock, mechanical ventilations/intubations, hospital charges, and length of stay. Prevalence for in-hospital mortality was lower in patients with obesity (2.2% vs 2.9%). Obese patients had higher adjusted odds for respiratory failure (aOR = 1.7, [(CI) 1.6-1.8]) and mechanical ventilation/intubation (aOR = 1.17, [(CI) 1.10-1.2]). They also had longer length of stays (aMD = 0.4 days, [(CI) 0.25-0.58 days] and higher total hospital charges (aMD = $5,561, [(CI) $3,638-$7,483]. Trends of in-hospital mortality for patients with obesity did not significantly increase (2.1% in 2010 to 2.4% in 2014, trend = 0.37), but significantly increased for obese patients (2.4% in 2010 to 3.4% in 2014; trend <0.01). Prevalence and trends of mortality were lower in patients with obesity hospitalized for opiate/opioid overdose compared to those without obesity between 2010 and 2014 in the United States.