Presentation (CTI)

OBJECTIVES: Opioid use disorder (OUD) affects approximately 2.1 million people in the United States and was associated with nearly 80,000 deaths in 2023. Opioid-related hospitalizations have increased by more than 70%, with inpatient stay rates rising from 136.8 per 100,000 population in 2005 to 232.6 per 100,000 in 2024. Patients with OUD have elevated 30-day hospital readmission rates, a key quality metric for hospitals and payers. The purpose of this study was to identify the predictors of 30-day hospital readmission among hospitalized patients with OUD using electronic health record data.
METHODS: A retrospective cohort study was conducted among adult patients hospitalized with OUD using the Medical Information Mart for Intensive Care (MIMIC)-IV database (N = 10,113). The primary outcome was all-cause 30-day hospital readmission. Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS: The area under the receiver operating characteristic curve was 0.67. Higher odds of 30-day readmission were associated with greater prior hospital utilization (OR=1.10, 95% CI [1.09-1.12]), longer length of stay (OR=1.01, 95% CI [1.00-1.01]), depression (OR=1.30, 95% CI [1.18-1.43]), chronic pain (OR=1.25, 95% CI [1.13-1.39]), and hepatitis C infection (OR=1.48, 95% CI [1.30-1.69]). African American patients had higher odds of readmission compared with Caucasian patients (OR=1.33, 95% CI [1.16-1.53]). Receipt of medications for opioid use disorder (MOUD) was associated with lower odds of 30-day readmission (OR=0.86, 95% CI [0.77-0.97]).
CONCLUSIONS: Among patients hospitalized with OUD, 30-day readmission risk was driven primarily by prior healthcare utilization and comorbid mental and physical health conditions. Additionally, African Americans may need more focused interventions compared to Caucasian patients. Receipt of MOUD during hospitalization was associated with a lower risk of readmission, highlighting the importance of providing evidence-based OUD treatment during hospitalization.