After nonfatal opioid overdose, 1 in 20 patients dies within a year

Takeaway

• Patients discharged from emergency departments (EDs) after surviving an acute opioid overdose are at high risk for death in the ensuing year, especially in the first few days and weeks after discharge.
• Authors say that this initial contact in the ED is a "critical period for interventions," including buprenorphine initiation, naloxone distribution, counseling, and referral.
• The findings support rapid adoption of medication for treatment programs and other interventions for these patients, say the authors.

Why this matters

• Few studies address the fast-growing population of patients discharged alive from EDs after overdose.

Key results

• Mortality (95% CIs):
  • 1 year: 5.5% (5.08%-5.92%).
  • 1 month: 1.1% (0.94%-1.33%).
  • 2 days: 0.25% (0.17%-0.36%).
• Among those who died:
  • 67.4% died of opioid overdose.
  • 20.5% died within 1 month.
• Among those who died within 1 month, 22.4% died within 2 days.

Study design

• Retrospective observational statewide study of patients discharged from ED after opioid overdose, 2011-2015 (n=11,557).
• Data sets included master demographics list, acute care hospital database, Massachusetts death records.
• Outcome: 1-year all-cause mortality after first overdose.
• Funding: None disclosed.

Limitations

• Data set would not capture presentations or deaths outside Massachusetts.