OUD in VOC -- Longer Hospital Stays, Higher Costs

Background: Patients with sickle cell disease (SCD) are often hospitalized due to vaso-occlusive crises (VOC) with need for opioids for adequate pain treatment. However, concerns about opioid use disorder (OUD) and overdoses have led to hesitation among health care providers, contributing to patient dissatisfaction and perceptions of bias. Although studies estimate opioid addiction rates among SCD patients to be between 3% and 10%, where addiction is defined as substance dependence to avoid withdrawal symptoms based on DSM-IV criteria, only 2% of these patients have substance dependence unrelated to pain. The impact of OUD on health care outcomes has not been previously studied. Objective: To assess the associations between OUD and health care outcomes, including length of stay (LOS), costs, and mortality, in adult patients hospitalized with VOC. Design: Retrospective cohort study using the National Inpatient Sample (NIS) database from 2016 to 2019. Methods: The authors evaluated the more...