Reasons for emergency department visits of patients with opioid use disorder at an urban safety-net hospital: A retrospective records review

Shawkut Ali; Shona Lowe; James S. George; Christopher Brown; Gloria Sanchez; Bernadette Pendergraph

doi:10.5055/jom.0810

Authors

Shawkut Ali, MD
Shona Lowe, MD
James S. George, MD
Christopher Brown, MD
Gloria Sanchez, MD
Bernadette Pendergraph, MD

DOI:

https://doi.org/10.5055/jom.0810

Keywords:

opioid-related disorders, emergency service, hospital, substance-related disorders, diabetes mellitus, primary healthcare

Abstract

Objectives: The purpose of this study was to describe the emergency department (ED) visit chief complaints and discharge diagnoses of patients with an opioid use disorder (OUD) empaneled to a primary care clinic.

Design: ED visits were retrospectively reviewed through electronic health records. Patients with a history of using multiple substances and medical or psychiatric conditions were compared to those without these conditions.

Setting: This study was conducted at Harbor-UCLA ED, a safety-net level one trauma center.

Patients and participants: Eligible participants were empaneled to the Harbor-UCLA Family Health Center with a diagnosis of OUD between January 1, 2018, and December 31, 2020.

Main outcome measures: The primary outcome measures included number of ED visits, hospital admissions, chief complaints, and discharge diagnoses.

Results: The total number of patients was 59. The most common chief complaints were musculoskeletal (34 percent), gastrointestinal (18 percent), general (13 percent), and skin (8.6 percent). The most common discharge diagnoses were musculoskeletal (27 percent), gastrointestinal (20 percent), infectious (11 percent), substance use disorder related (11 percent), psychiatric (7 percent), and cardiovascular (7 percent). Co-occurring alcohol use was associated with a higher number of visits, 3.18 versus 1.15 (p = 0.021), and a higher percentage of patients with frequent visits, 46 percent versus 8 percent (p = 0.008). Patients with diabetes had more frequent visits, 40 percent versus 10 percent (p = 0.036), and were more likely to be admitted, 43 percent versus 15 percent (p = 0.010).

Conclusions: This study highlights the importance of screening and the management of alcohol use and diabetes among patients with OUD.

Author Biographies

Shawkut Ali, MD

Addiction Medicine Fellow, Augusta University, Psychiatry and Health Behavior, Augusta, Georgia

Shona Lowe, MD

Addiction Medicine Fellow, Harbor-UCLA Family Medicine, Harbor City, California

James S. George, MD

Resident Physician, Advocate Lutheran General Hospital, Park Ridge, Illinois

Christopher Brown, MD

Assistant Professor of Medicine, Harbor-UCLA Internal Medicine, Torrance, California

Gloria Sanchez, MD

Associate Clinical Professor of Family Medicine, Harbor-UCLA Family Medicine, Harbor City, California

Bernadette Pendergraph, MD

Associate Clinical Professor of Family Medicine, Harbor-UCLA Family Medicine, Harbor City, California

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