Trends and Outcomes of Opioid-Related Cardiac Arrest in a Contemporary US Population

Authors

Senada S. Malik, New York, United States.Follow
Wilbert S. Aronow, Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY, United States.Follow
Alexandros Briasoulis, Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics & National Kapodistrian University of Athens, Greece. Electronic address: alexandros-briasoulis@uiowa.edu.

Author Type(s)

Faculty

DOI

10.1016/j.ejim.2021.11.004

Journal Title

European Journal of Internal Medicine

First Page

122

Last Page

124

Document Type

Letter to the Editor

Publication Date

3-1-2022

Department

Medicine

Keywords

Cardiac arrest, Opioid abuse

Disciplines

Medicine and Health Sciences

Abstract

BACKGROUND: Opioid abuse is a worldwide public health issue, and deaths related to opioid abuse are increasing. We aimed to investigate trends, predictors, and outcomes of cardiac arrest in patients with opioid abuse. METHODS: All hospitalizations for primary diagnosis of cardiac arrest between 2012 and 2018 identified in the Nationwide Inpatient Sample were categorized into those with or without a secondary diagnosis of opioid overdose. Multivariable logistic regression was used to analyze in-hospital outcomes of opioid-associated cardiac arrest after adjusting for patient and hospital characteristics. RESULTS: Among 1,410,475 hospitalizations with cardiac arrest, opiate abuse as a secondary diagnosis was found in 3.1% (n=43,090) of hospitalizations, with an increasing trend during the study period. Hospitalizations for cardiac arrest with opioid abuse were seen less likely in patients with heart failure (21.2% vs. 40.6%; p<0.05), diabetes mellitus (19.5% vs. 35.4%; p<0.05), hypertension (43.4% vs. 64.9%; p<0.05) and renal failure (14.3% vs. 30.2%; p<0.05) and more frequently in those with history of alcohol abuse (16.9% vs. 7.1%; p<0.05), depression (18.8% vs. 9%; p<0.05), and smoking (37.0% vs. 21.8%; p<0.05) as compared with cardiac arrest without opioid use. In-hospital mortality in cardiac arrest patients with and without opioids was not different after multivariable adjustment (odds ratio OR 0.96, 0.91-1.00; p=0.07). OA-OHCA was associated with significantly higher risks of acute kidney injury, acute respiratory failure, and mechanical ventilation, p<0.05 for all. CONCLUSION: Opioid abuse remains a significant cause of cardiac arrest. Despite similar in-hospital mortality and lower resource utilization, severe complications are more frequent in opioid abuse related cardiac arrests compared to those without opioid abuse.

Recommended Citation

Malik, S. S., Aronow, W. S., & Briasoulis, A. (2022). Trends and Outcomes of Opioid-Related Cardiac Arrest in a Contemporary US Population. European Journal of Internal Medicine, 97, 122-124. https://doi.org/10.1016/j.ejim.2021.11.004