Opioid dependence and treatment outcomes among patients with burn injury

Abstract

Background: Patients with burn injuries cause significant healthcare economic burden, often utilising extra-hospital resources, caregiving, and specialized care.

Methods: We present a retrospective cohort analysis of the hospitalized patients in the USA with a primary diagnosis of burn injury. Opioid dependence was identified using ICD-10 CM codes. The 30-day all-cause readmission rate was the main outcome while secondary outcomes were inhospital mortality rate, resource utilization which included hospital length of stay, total hospitalization costs and charges and surgical procedures for burn injury treatment as well as the most important five principal diagnoses for admission and readmission.

Results: Out of 22,348 patients included in the study, 597 had opioid dependence. Older patients (43 years, range: 38.6-47.2 years) as well as males (70.8%) were more likely to be opioid dependent. Opioid dependence was associated with higher 30-day readmission rates (aOR: 1.83, 95% confidence interval (CI): 1.30-2.57, p-value: <0.01), higher total hospitalization costs (aMD: $14,981, CI: $3820-$26,142, p-value: 0.01), total hospitalization charges (aMD: $47,078, CI: -$5093 to $89,063, p-value: 0.03), and a shorter mean length of stay (aMD: 5.13 days, CI: 2.60-7.66, p-value: <0.01). However, patients with and without opioid dependence had similar in-hospital mortality rates (aOR: 0.27, CI: 0.06-1.28, p-value: 0.10).

Conclusion: We are the first to our knowledge to report the association of treatment outcomes and opioid dependence in patients hospitalized at the national level with a burn injury. We show that there were higher 30-day all-cause readmission rates and in-hospital resource utilization among patients with opioid-dependence.

Keywords: Burn injury; Opioid abuse; Opioid dependence; Readmission; Resource utilization.