Acute pain and self-directed discharge among hospitalized patients with opioid-related diagnoses: a cohort study

Original research
par
Compton, Peggy et al

Date de publication

2021

Géographie

USA

Langue de la ressource

English

Texte disponible en version intégrale

Oui

Open Access / OK to Reproduce

Oui

Évalué par des pairs

Yes

L’objectif

Inadequate pain management has been identified as a potential motivator of self-directed discharge in this patient population. The objective of this study was to describe the association between acute pain and self-directed discharges among persons with opioid-related conditions; the presence of chronic pain in self-directed discharges was likewise considered.

Constatations/points à retenir

Sixteen percent of the 7972 admissions involving opioid-related conditions culminated in self-directed discharge, which was more than five times higher than in the general population. Self-directed discharge rates were positively associated with polysubstance use, nicotine dependence, depression, and homelessness. Among the 955 patients with at least one self-directed discharge, 15.4% had up to 16 additional self-directed discharges during the 12-month observation period. Those admitted with an acutely painful diagnosis were almost twice as likely to complete a self-directed discharge, and for patients with multiple admissions, rates of acutely painful diagnoses increased with each admission coinciding with a cascading pattern of worsening infectious morbidity over time.

La conception ou méthodologie de recherche

We employed a large database of all hospitalizations at acute care hospitals during 2017 in the city of Philadelphia to identify adults with opioid-related conditions and compare the characteristics of admissions (n=7972) ending with routine discharge versus those ending in self-directed discharge.

Mots clés

About PWUD
Outcomes
Housing
Chronic pain
Mental health
Hospitals