Bodapati Naga Venkata Satish Babu, Patel Sandipkumar, Sihman Bharattej Rupavath Rana Veer Samara, Polu Omkar Reddy, Chamarthi Balaiah, Anna Joseph Chrishanti
Department of Psyhciatry, Sunshine Behavioral Health Services, Bakersfield, USA.
Department of Computer Engineering, Gujarat Technological University, Ahmedabad, IND.
Cureus. 2025 Mar 29;17(3):e81405. doi: 10.7759/cureus.81405. eCollection 2025 Mar.
Opioid use disorder (OUD) is associated with significantly increased mortality rates compared to the general population, driven by overdose risk, high-risk behaviors, and comorbid conditions. While opioid agonist treatment reduces mortality, identifying risk factors for death among individuals with OUD remains critical for improving outcomes.
A retrospective analysis of the 2020 National Readmission Database identified OUD admissions using International Classification of Diseases, 10th Revision, Clinical Modification codes. Patients over 18 years of age were included, and statistical analyses, including logistic regression, assessed 30-day readmission and mortality predictors. Data were analyzed using IBM Statistical Package for the Social Sciences Statistics for Windows, version 1.0.0.1327 (IBM Corp., Armonk, NY).
Nonsurvivors were generally older (median age: 58 vs. 47 years) and had a higher prevalence of severe comorbidities, including cardiac arrest (24.1% vs. 0.4%, p < 0.001), respiratory failure (83.0% vs. 16.2%, p < 0.001), and acute kidney injury (61.9% vs. 16.8%, p < 0.001). Mortality was more common among patients with Medicare (44.4% vs. 31.7%) and in larger hospitals. Psychiatric conditions, such as depression and suicidal ideation, were more frequent in survivors, suggesting potential protective effects or earlier intervention. Multivariable analysis identified cardiac arrest (odds ratio, OR: 20.210, p < 0.001), respiratory failure (OR: 9.993, p < 0.001), and liver failure (OR: 4.298, p < 0.001) as the strongest mortality predictors, while female sex and psychiatric disorders were associated with lower mortality risk.
Mortality among patients with OUD is influenced by age, comorbidities, hospital characteristics, and healthcare disparities. Integrated care approaches that address both medical and psychiatric conditions are essential for improving survival outcomes. Future research should focus on targeted interventions to mitigate high-risk factors and enhance harm reduction strategies for this vulnerable population.
与普通人群相比，阿片类物质使用障碍（OUD）导致死亡率显著增加，其原因包括过量用药风险、高危行为和合并症。虽然阿片类激动剂治疗可降低死亡率，但确定OUD患者的死亡风险因素对于改善治疗结果仍然至关重要。
对2020年国家再入院数据库进行回顾性分析，使用国际疾病分类第十次修订本临床修订版代码确定OUD入院患者。纳入18岁以上患者，并进行包括逻辑回归在内的统计分析，以评估30天再入院率和死亡预测因素。使用IBM社会科学统计软件包Windows版1.0.0.1327（IBM公司，纽约州阿蒙克）对数据进行分析。
非幸存者通常年龄较大（中位年龄：58岁对47岁），严重合并症的患病率较高，包括心脏骤停（24.1%对0.4%，p<0.001）、呼吸衰竭（83.0%对16.2%，p<0.001）和急性肾损伤（61.9%对16.8%，p<0.001）。医疗保险患者的死亡率更高（44.4%对31.7%），且在较大的医院中更为常见。精神疾病，如抑郁症和自杀意念，在幸存者中更为常见，提示可能具有保护作用或更早的干预。多变量分析确定心脏骤停（比值比，OR：20.210，p<0.001）、呼吸衰竭（OR：9.993，p<0.001）和肝功能衰竭（OR：4.298，p<0.001）是最强的死亡预测因素，而女性和精神疾病与较低的死亡风险相关。
OUD患者的死亡率受年龄、合并症、医院特征和医疗保健差异的影响。综合治疗方法，即同时解决医疗和精神疾病问题，对于改善生存结果至关重要。未来的研究应侧重于针对性干预措施，以减轻高危因素，并加强针对这一弱势群体的减少伤害策略。
