Bode Anna L, Borja-Montes Oscar F, Quazi Mohammed A, Mumtaz Aqsa, Sohail Amir H, Smith Christopher R, Khawaja Muhammad Rizwan, Sheikh Abu Baker
Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA.
Department of Family and Community Health, West Virginia University, Morgantown, WV, USA.
Ann Hematol. 2025 Mar;104(3):1551-1561. doi: 10.1007/s00277-025-06236-x. Epub 2025 Mar 10.
Sickle cell disease (SCD) predominantly affects individuals of African descent and is characterized by frequent painful vaso-occlusive crises, often requiring opioid management. With the opioid epidemic raising concerns about opioid overdose, this study examines in-hospital outcomes among SCD and non-SCD patients hospitalized for opioid overdose. Using the National Inpatient Sample (NIS) from 2016 to 2021, we analyzed 479,175 opioid overdose hospitalizations, including 1,315 (0.3%) with a concomitant diagnosis of SCD. Propensity score matching was used to balance demographics, comorbidities, and hospital characteristics. SCD patients were younger (45.3% aged 30-49 vs. 33.1%, p < 0.001), predominantly of African descent (92.1% vs. 14.1%, p < 0.001), and more often from lower-income households (58.4% vs. 35.2%, p < 0.001). SCD patients had lower rates of mechanical ventilation (aOR: 0.7, 95% CI: 0.6-0.9) and anoxic brain injury (aOR: 0.5, 95% CI: 0.4-0.8) but experienced longer hospital stays and higher costs. No significant differences in in-hospital mortality were observed (aOR: 0.89, 95% CI: 0.7-1.1, p = 0.34). These findings emphasize the need for a nuanced approach to managing SCD patients during opioid overdose hospitalizations, focusing on mitigating complications, addressing prolonged hospital stays and higher costs, and reducing healthcare disparities through tailored strategies informed by the unique needs of this population.
镰状细胞病（SCD）主要影响非洲裔个体，其特征是频繁发生疼痛性血管闭塞危机，常需使用阿片类药物治疗。随着阿片类药物流行引发对阿片类药物过量的担忧，本研究调查了因阿片类药物过量住院的SCD患者和非SCD患者的院内结局。利用2016年至2021年的全国住院患者样本（NIS），我们分析了479175例阿片类药物过量住院病例，其中1315例（0.3%）同时诊断为SCD。采用倾向得分匹配法来平衡人口统计学、合并症和医院特征。SCD患者更年轻（30 - 49岁的患者占45.3%，而非SCD患者占33.1%，p < 0.001），主要为非洲裔（92.1% vs. 14.1%，p < 0.001），且更多来自低收入家庭（58.4% vs. 35.2%，p < 0.001）。SCD患者机械通气率（调整后比值比：0.7，95%置信区间：0.6 - 0.9）和缺氧性脑损伤率（调整后比值比：0.5，95%置信区间：0.4 - 0.8）较低，但住院时间更长且费用更高。未观察到院内死亡率有显著差异（调整后比值比：0.89，95%置信区间：0.7 - 1.1，p = 0.34）。这些发现强调，在阿片类药物过量住院期间，需要采取细致入微的方法来管理SCD患者，重点是减轻并发症、解决住院时间延长和费用增加的问题，并通过根据该人群独特需求制定的量身定制策略来减少医疗保健差距。
