Opioid Utility and Hospital Outcomes among Inpatients admitted with Osteoarthritis and Spine Disorders

To evaluate opioid analgesic utilization and predictors for adverse events during hospitalization and discharge disposition among patients admitted with osteoarthritis (OA) or spine disorders.This is a retrospective study of 12,747 adult patients admitted to 6 private community hospitals from 2017 to 2020. Opioid use during hospitalization and risk factors for hospital-acquired adverse events and non-home discharge were investigated.The total number of patients using opioids decreased, however, the daily morphine milligram equivalent (MME) use for patients on opioids increased from 2017 to 2020. Increased odds of non-home discharge were associated with older age, Medicaid, Medicare insurance, and increased lengths of stay (LOS), increased body mass index, daily MME, and electrolyte replacement in the OA group. In the spine group, older age, black race, Medicaid, Medicare, no insurance, increased Charlson comorbidity index (CCI), LOS, polypharmacy, and heparin use were associated with non-home discharge. Adverse events were associated with increased age, LOS, Medicare, polypharmacy, antiemetic, and benzodiazepine use in the OA group and increased CCI, LOS, and electrolyte replacement in the spine group.Despite the decreasing number of patients using opioids over the years, patients on opioids had an increased daily MME over the same time period.