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Brief report: Cannabis and opioid use disorder among heart failure admissions, 2008-2018
Fouad Chouairi1, Clancy W Mullan2, Neal Ravindra3,4
1Department of Internal Medicine, Duke University Medical Center, Durham, NC, United States of America.
Insights
Cannabis use disorder (CUD) and opioid use disorder (OUD) are increasingly common in heart failure (HF) admissions, affecting younger, minority, and lower socioeconomic status populations and increasing healthcare costs.
Area of Science:
- Cardiology
- Public Health
- Addiction Medicine
Background:
- Rising prevalence of cannabis use disorder (CUD) and opioid use disorder (OUD) in the U.S.
- Limited understanding of CUD and OUD impact on heart failure (HF) admissions.
- Need to investigate CUD and OUD demographics and costs in HF patients.
Purpose of the Study:
- To examine the prevalence of CUD and OUD in HF admissions.
- To analyze the demographics and associated costs of CUD and OUD in HF patients.
- To identify trends in CUD and OUD co-diagnoses within HF admissions.
Main Methods:
- Utilized the National Inpatient Sample (NIS) from 2008-2018.
- Identified HF admissions with and without CUD or OUD using ICD codes.
- Analyzed demographic data, hospitalization costs, and temporal trends.
Main Results:
- HF admissions with CUD increased from 0.3% to 1.3%; OUD increased from 0.2% to 1.1% (2008-2018).
- Patients with HF and CUD/OUD were younger, more likely Black, and from lower socioeconomic backgrounds.
- HF admissions with CUD/OUD incurred higher median costs compared to those without ($8,611/$10,019 vs. $8,337).
Conclusions:
- CUD and OUD prevalence is rising among HF admissions.
- These disorders disproportionately affect underserved populations and increase healthcare costs.
- Further research is needed to understand cost drivers and develop targeted interventions for CUD/OUD in HF.
Background:
In the United States, both cannabis use disorder (CUD) and opioid use disorder (OUD) have increased in prevalence. The prevalence, demographics, and costs of CUD and OUD are not well known in heart failure (HF) admissions. This study aimed to use a national database to examine the prevalence, demographics, and costs associated with CUD and OUD in HF.
Methods:
This study used the National Inpatient Sample from 2008 to 2018 to identify all primary HF admissions with and without the co-diagnosis of OUD or CUD using International Classification for Diagnosis, diagnosis codes. Demographics, costs, and trends were examined.
Results:
Between 2008 and 2018, we identified 11,692,995 admissions for HF of which 84,796 (0.8%) had a co-diagnosis of CUD only, and 67,137 (0.6%) had a co-diagnosis of OUD only. The proportion of HF admissions with CUD significantly increased from 0.3% in 2008 to 1.3% in 2018 (p<0.001). The proportion of HF admissions with OUD significantly increased from 0.2% in 2008 to 1.1% in 2018 (p<0.001). Patients admitted with HF and either CUD or OUD were younger, more likely to be Black, and from lower socioeconomic backgrounds (p<0.001, all). HF admissions with OUD or CUD had higher median costs compared to HF admissions without associated substance abuse diagnoses ($8,611 vs. $8,337 for CUD HF and $10,019 vs. $8,337 for OUD HF, p<0.001 for both).
Conclusions:
Among discharge records for HF, CUD and OUD are increasing in prevalence, significantly affect underserved populations and are associated with higher costs of stay. Future research is essential to better delineate the cause of these increased costs and create interventions, particularly in underserved populations.
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