EFFECT OF OPIOID ABUSE AND DEPENDANCE ON OUTCOMES OF PATIENTS HOSPITALIZED WITH COPD: A 5-YEAR ANALYSIS

Abstract

SESSION TITLE: Obstructive Lung Diseases 2 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: Use of opioids is prevalent in patients with COPD which raises concern about potential respiratory complications in this population. The aim of this study is to analyze the outcomes of patients admitted for COPD or COPD exacerbation with a history of opioid abuse or dependence. METHODS: This is a retrospective propensity score matched analysis utilizing the 2010 to 2014 Nationwide Inpatient Sample, the largest inpatient database in the United States. The study population comprised of 23,074 patients over age 18 with a primary diagnosis of COPD or COPD exacerbation with and without a secondary diagnosis of opioid abuse or dependence. The outcomes of interest were mortality, non-invasive ventilation (NIV) use, endotracheal intubation and length of stay. Multivariate logistic regression was performed to test for independent associations between variables of interest. Diagnoses and procedures were identified using ICD-9-CM codes. Analysis was performed using STATA 14.2. RESULTS: Patients in the opioid group were more likely to be intubated during hospitalization when compared to non-opioid users (OR 1.68, p<0.05). However, no difference in mortality was seen (OR 0.53, p=0.182). NIV utilization did not differ among the groups (OR 1.05 p=0.67) and no difference in length of stay was found (additional 0.042 days, p=0.3). CONCLUSIONS: Opioid dependence and abuse increase the risk of intubation in patients hospitalized for COPD but did not affect mortality. No differences were seen in NIV utilization or length of stay. Further research is needed to better understand the role of chronic opioid use and abuse in patients admitted for COPD. CLINICAL IMPLICATIONS: Clinicians should be aware of the potential adverse respiratory outcomes of opioid dependance or abuse in patients who are hospitalized for COPD related complications. DISCLOSURES: No relevant relationships by Felipe Bolivar Rincon, source=Web Response No relevant relationships by Joseph Mathew, source=Web Response No relevant relationships by Christian Olivo Freites, source=Web Response No relevant relationships by Di Pan, source=Web Response No relevant relationships by Sathish Pondaiah, source=Web Response No relevant relationships by Fernando Vazquez de Lara, source=Web Response