Characteristics of Nonfatal Opioid Overdose in Emergency Department Patients Surviving to Discharge or Hospital Admission

Emergency department (ED) presentations for opioid overdose have risen significantly over the past decade. Many of these visits result in hospital admission, with substantial public health and economic consequences. Much is unknown about the patients and about hospital characteristics associated with discharge versus inpatient admission for these patients. We investigated patient and hospital characteristics associated with nonfatal ED visits for opioid overdose associated with hospital admission. Using 2016 data from the Nationwide Emergency Department Sample, we performed a cross-sectional analysis and identified a weighted estimate of adult patients presenting to EDs across the United States with , diagnoses consistent with opioid overdose. Disposition, sex, age, expected payer, income quartile, geographic region, type of opioid ingested, co-ingestions, urban/rural designation, and teaching status of hospital were examined. Logistic regression (proc surveylogistic) was used to identify predictors of hospital admission for overdose. Odds ratios and their associated 95% confidence intervals are reported. In 2016, there were 263,621 adult ED presentations for opioid overdose, and 25.5% of the ED patients were admitted to the hospital. Although rates of overdose (per 100,000) were higher in the Northeast (110.6) and the Midwest (106.4), admission rates were higher in the South (29.4%) and the West (30.7%). Factors associated with hospital admission included female sex, older age, having any type of insurance, nonheroin overdoses, and benzodiazepine co-ingestions. Understanding the characteristics associated with inpatient admission of patients presenting to the ED with opioid overdose represents an important area for ongoing and future public health intervention.