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One-year risk of opioid use disorder after index hospitalization for inflammatory bowel disease

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Patients with inflammatory bowel disease are commonly prescribed opiates for pain. We sought to determine the incidence of opiate use disorder after inflammatory bowel disease (IBD) admission over a 1-year period as well as its impact on mortality and hospital resource utilization.

Methods

The Nationwide Readmission Database 2016 was used to identify adult patients with a principal diagnosis of IBD who were subsequently readmitted with a primary diagnosis of opioid use disorder. The primary outcome was 1-year readmission rate for opiate use disorder. Predictors were analyzed using multivariate logistic regression. Secondary outcomes were mortality rate, length of stay, and total hospital costs and charges.

Results

Among the 6340 index hospitalizations for IBD, 4.7% (6.0% Crohn’s and 2.6% ulcerative colitis) were readmitted within 1 year for opiate use disorder. Readmission hospitalizations were associated with additional mortality (0.32%) and hospital utilization (length of stay 4.80 days, mean total costs $9503, and mean total charges $38,288). Ulcerative colitis had significantly higher mortality and hospital utilization costs compared with Crohn’s disease. In multivariable analysis, odds of readmission were associated with female sex (OR 1.51, CI 1.19–1.92), private insurance (OR 0.20, CI 0.11–0.37), Charlson Comorbidity Index (OR 0.20, CI 0.11–0.37), anxiety (OR 1.65, CI 1.02–2.63), and depression (OR 2.07, CI 1.28–3.34). On stratification analysis, psychiatric comorbidities were associated with both Crohn’s and ulcerative colitis.

Conclusion

Patients with IBD were often readmitted for opiate use disorder and sustained significant mortality and hospital costs. Psychiatric comorbidities, gender, and insurance status impacted the odds of readmission and represent targets for intervention.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, New Brunswick, NJ, 08901, USA

    Mishal Reja, Nitya Hajela & Michael Makar

  2. Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Daniel Marino

  3. Department of Gastroenterology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Abhishek Bhurwal

  4. Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, USA

    Vinod Rustgi

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  1. Mishal Reja
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All authors worked in all 4 aspects of authorship as per the ICMJE guidelines.

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Correspondence to Mishal Reja.

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Institutional Review Board approval and informed consent were not required for the current study because all data collection was derived from a de-identified administrative database.

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The authors declare that they have no conflict of interest.

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This study was conducted at Rutgers Robert Wood Johnson School of Medicine.

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Reja, M., Hajela, N., Makar, M. et al. One-year risk of opioid use disorder after index hospitalization for inflammatory bowel disease. Int J Colorectal Dis 35, 2081–2087 (2020). https://doi.org/10.1007/s00384-020-03691-y

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  • DOI: https://doi.org/10.1007/s00384-020-03691-y

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