Vikram Jairam1, Daniel X Yang1, James B Yu1,2, Henry S Park1,2. 1. Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, USA. 2. Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, CT, USA.
Abstract
BACKGROUND: Patients with cancer may be at risk of high opioid use due to physical and psychosocial factors, although little data exist to inform providers and policymakers. Our aim is to examine overdoses from opioids leading to emergency department (ED) visits among patients with cancer in the United States. METHODS: The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample was queried for all adult cancer-related patient visits with a primary diagnosis of opioid overdose between 2006 and 2015. Temporal trends and baseline differences between patients with and without opioid-related ED visits were evaluated. Multivariable logistic regression analysis was used to identify risk factors associated with opioid overdose. All statistical tests were two-sided. RESULTS: Between 2006 and 2015, there were a weighted total of 35 339 opioid-related ED visits among patients with cancer. During this time frame, the incidence of opioid-related ED visits for overdose increased twofold (P < .001). On multivariable regression (P < .001), comorbid diagnoses of chronic pain (odds ratio [OR] 4.51, 95% confidence interval [CI] = 4.13 to 4.93), substance use disorder (OR = 3.54, 95% CI = 3.28 to 3.82), and mood disorder (OR = 3.40, 95% CI = 3.16 to 3.65) were strongly associated with an opioid-related visit. Patients with head and neck cancer (OR = 2.04, 95% CI = 1.82 to 2.28) and multiple myeloma (OR = 1.73, 95% CI = 1.32 to 2.26) were also at risk for overdose. CONCLUSIONS: Over the study period, the incidence of opioid-related ED visits in patients with cancer increased approximately twofold. Comorbid diagnoses and primary disease site may predict risk for opioid overdose.
BACKGROUND:Patients with cancer may be at risk of high opioid use due to physical and psychosocial factors, although little data exist to inform providers and policymakers. Our aim is to examine overdoses from opioids leading to emergency department (ED) visits among patients with cancer in the United States. METHODS: The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample was queried for all adult cancer-related patient visits with a primary diagnosis of opioid overdose between 2006 and 2015. Temporal trends and baseline differences between patients with and without opioid-related ED visits were evaluated. Multivariable logistic regression analysis was used to identify risk factors associated with opioid overdose. All statistical tests were two-sided. RESULTS: Between 2006 and 2015, there were a weighted total of 35 339 opioid-related ED visits among patients with cancer. During this time frame, the incidence of opioid-related ED visits for overdose increased twofold (P < .001). On multivariable regression (P < .001), comorbid diagnoses of chronic pain (odds ratio [OR] 4.51, 95% confidence interval [CI] = 4.13 to 4.93), substance use disorder (OR = 3.54, 95% CI = 3.28 to 3.82), and mood disorder (OR = 3.40, 95% CI = 3.16 to 3.65) were strongly associated with an opioid-related visit. Patients with head and neck cancer (OR = 2.04, 95% CI = 1.82 to 2.28) and multiple myeloma (OR = 1.73, 95% CI = 1.32 to 2.26) were also at risk for overdose. CONCLUSIONS: Over the study period, the incidence of opioid-related ED visits in patients with cancer increased approximately twofold. Comorbid diagnoses and primary disease site may predict risk for opioid overdose.
Authors: Frank X Scheuermeyer; Christopher DeWitt; Jim Christenson; Brian Grunau; Andrew Kestler; Eric Grafstein; Jane Buxton; David Barbic; Stefan Milanovic; Reza Torkjari; Indy Sahota; Grant Innes Journal: Ann Emerg Med Date: 2018-03-09 Impact factor: 5.721
Authors: Paul A Glare; Pamela S Davies; Esmé Finlay; Amitabh Gulati; Dawn Lemanne; Natalie Moryl; Kevin C Oeffinger; Judith A Paice; Michael D Stubblefield; Karen L Syrjala Journal: J Clin Oncol Date: 2014-05-05 Impact factor: 44.544
Authors: Nina N Sanford; David J Sher; Santino S Butler; Xiaohan Xu; Chul Ahn; Ayal A Aizer; Brandon A Mahal Journal: Cancer Date: 2019-08-22 Impact factor: 6.860
Authors: William H Smith; Ian Luskin; Lucas Resende Salgado; Bethann M Scarborough; Jung-Yi Lin; Umut Özbek; Brett A Miles; Vishal Gupta; Richard L Bakst Journal: Oral Oncol Date: 2019-03-12 Impact factor: 5.337
Authors: Donna R Rivera; Lisa Gallicchio; Jeremy Brown; Benmei Liu; Demetrios N Kyriacou; Nonniekaye Shelburne Journal: JAMA Oncol Date: 2017-10-12 Impact factor: 31.777
Authors: Jacob C Cogan; Rohit R Raghunathan; Melissa P Beauchemin; Melissa K Accordino; Elena B Elkin; Alexander Melamed; Jason D Wright; Dawn L Hershman Journal: Breast Cancer Res Treat Date: 2021-06-04 Impact factor: 4.872
Authors: Derrick C Gibson; Mukaila A Raji; Holly M Holmes; Jacques G Baillargeon; Yong-Fang Kuo Journal: Mayo Clin Proc Date: 2022-02-05 Impact factor: 7.616
Authors: Lucas K Vitzthum; Vinit Nalawade; Paul Riviere; Mallika Marar; Timothy Furnish; Lewei A Lin; Reid Thompson; James D Murphy Journal: J Natl Cancer Inst Date: 2022-05-09 Impact factor: 11.816
Authors: Andrew W Roberts; Samantha Eiffert; Elizabeth M Wulff-Burchfield; Stacie B Dusetzina; Devon K Check Journal: J Natl Cancer Inst Date: 2021-04-06 Impact factor: 13.506
Authors: Lucas K Vitzthum; Vinit Nalawade; Paul Riviere; Whitney Sumner; Tyler Nelson; Loren K Mell; Timothy Furnish; Brent Rose; María Elena Martínez; James D Murphy Journal: JCO Oncol Pract Date: 2021-02-03