SCD patients face longer opioid overdose hospital stays: Study
Patients see fewer complications, but higher costs and special challenges
People with sickle cell disease (SCD) who are hospitalized for opioid overdose have fewer serious complications than those without the condition, but face longer hospital stays, higher costs, and unique healthcare challenges that require specialized care, a study found.
“A multidisciplinary approach to pain management, tailored to individual patient needs and aligned with established guidelines, is crucial for improving outcomes and reducing complications in SCD,” they wrote.
The study, “Sickle cell disease and opioid overdose outcomes in the United States: a nationwide analysis,” was published in the Annals of Hematology.
In SCD, abnormally shaped red blood cells block blood vessels and compromise oxygen delivery to body tissues. This can cause sudden episodes of severe pain, called vaso-occlusive crises. These painful episodes sometimes require patients to take strong analgesics, such as opioids.
The way opioids are used in SCD will depend on the type and severity of pain a patient is experiencing, but because they’re highly addictive and come with serious risks, they’re usually only prescribed when pain cannot be controlled by other medications.
With the opioid epidemic “raising concerns about opioid overdose,” the researchers said, they undertook the study to understand how SCD patients respond when treated for opioid overdoses. “The opioid overdose crisis is a well-recognized public health issue that has been exacerbated since the onset of the opioid epidemic,” they wrote.
Hospital records show differences
The researchers looked at hospital records from the U.S. National Inpatient Sample (NIS) from 2016 to 2021. Of the 479,175 records of hospitalization for opioid overdose, 1,315 (0.3%) involved adults and adolescents with SCD. To make fair comparisons, these patients were matched to patients without SCD based on age, income, and other diseases.
On average, people with SCD who were admitted to the hospital for opioid overdose were younger than those without SCD, and more likely to be female (54.4% vs. 48%). They were also more likely to come from lower-income households (58.4% vs. 35.2%) and to be of African descent (90.1% vs. 13.1%).
When researchers compared 1,315 people with SCD with a matched group of another 1,315 people without SCD, they found no significant differences in the rates of deaths occurring while in the hospital for opioid overdose treatment (3.4% vs. 2.8%).
While people with SCD had lower rates of serious complications, such as needing invasive mechanical ventilation to help with breathing (10.3% vs. 23.6%) or having brain damage due to lack of oxygen (1.5% vs. 5.7%), they stayed in the hospital longer (7.2 vs. 4.8 days) and incurred higher costs ($76,602.76 vs. $57,649.83).
“These findings emphasize the importance of a nuanced approach to managing SCD patients during opioid overdose hospitalizations, focusing on mitigating complications, addressing prolonged hospital stays and higher costs, and reducing healthcare disparities through tailored strategies informed by the unique needs of this population,” the researchers wrote.
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