Frequency of Cardiovascular Events and In-hospital Mortality With Opioid Overdose Hospitalizations

      The United States is in the kernel of cataclysmic opioid misuse epidemic with over 33,000 deaths per year from both prescription and illegal opioids use. One of the most common pernicious effects of opioids is on the cardiovascular system. The purpose of this analysis was to determine the incidence of opioid overdose associated cardiovascular events and its impact on short-term outcomes. This was a retrospective, observational study which utilized data from the National Inpatient Sample from January 2005 to September 2015 using International Classifications of Disease, Ninth Revision, Clinical Modification diagnosis codes to identify patients with opioid overdose and associated cardiovascular outcomes. Cardiovascular events were mainly divided into the following 3 parts: Ischemic Events (ischemic stroke and myocardial infarction), acute heart failure, and arrhythmias. The primary outcome of this study was incidence of any cardiovascular event. This study analyzed a total of 430,459 patients hospitalized with opioid overdose, out of which 36,837 (8.6%) had at least 1 cardiovascular event. In all the opioid overdose hospitalizations, 13,979 (3.2%) developed ischemic events, 3,074 (0.7%) developed acute heart failure, and 22,444 (5.2%) developed arrhythmia. Opioid overdose patients with new-onset cardiovascular events had higher odds for in-hospital mortality (odds ratio 4.55; 95% confidence interval 4.11 to 5.04, p <0.001) as compared to patients without cardiovascular events in the multivariable-adjusted model. This study group also demonstrated longer length of stay and higher cost of hospitalization associated with opioid overdose and associated cardiovascular outcome. In conclusion, opioid overdose is associated with higher rates of cardiovascular events, particularly ischemic events and cardiac arrhythmias. These adverse events eventually lead to higher mortality rates and more resource utilization.
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