189: PATIENT FACTORS ASSOCIATED WITH AN OPIOID-INDUCED RESPIRATORY DEPRESSION EVENT AND NEED FOR NALOXONE

Abstract

Introduction: The emergency department fosters a fast-paced culture that evaluates opioid overdose patients. According to the CDC, death rates involving synthetic opioids is roughly 67.9%. The only reversal method is to administer naloxone. Ideally, patients at risk of an opioid induced respiratory depression (OIRD) event would receive prophylactic naloxone to have at home as needed. There are a few tools that can be used to assess a patient’s risk for an opioid overdose; which includes, the Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) and Overdose Risk Score (ORS). The purpose of this study was to determine a two to three high yield patient characterizes that strongly correlate with an opioid overdose risk. Methods: A retrospective cohort that analyzed data from patients who presented to the emergency department for an OIRD event between August 2018 – August 2020 at MercyOne Des Moines and West Des Moines campuses. The independent variable was an OIRD event. The dependent variables included RIOSORD score > 10, Overdose Risk Score (ORS) > 450, RIOSORD score, and ORS. Results: Of the 240 patients identified, 161 patients had a chart review completed. A total of 148 patients had a RIOSORD greater than 10 (91% of patients). The average RIOSORD score was 29.01 and ranged from 0 – 67. A total of 18 patients had an ORS greater than 450 (11% of patients). The average ORS was 190.06 and ranged from 0 – 670. None of the individual patient variables listed in the RIOSORD score showed statistical significance to produce a RIOSROD score greater than 10. Conclusions: In this retrospective cohort, a RIOSORD score greater than 10 is a good indicator of a patient who would benefit from naloxone at discharge. ORS is not a reliable tool to screen patients who are at risk of an OIRD event. There were no statistically significant patient factors that correlated with a RIOSORD greater than 10. Therefore, providers should continue to assess the patient using the whole RIOSORD screening tool to determine naloxone needs.