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

Table 1 Characteristics of admissions by discharge type (routine versus self-directed) in Philadelphia general acute hospitals for patients with diagnosed opioid dependence or poisoning, 2017

	Total	Routine	Self-directed	p
All admissions (N)	7972	6728	1244
Median length of stay (IQR)	4 (2–6)	4 (2–7)	2 (1–3)	< .0001
Male	4426 (55.5)	3653 (54.3)	773 (62.1)	< .0001
Average age (Std)	41.44 (12.1)	41.89 (12.3)	38.97 (11.0)	< .0001
Homeless^a	615 (7.7)	479 (7.1)	136 (10.9)	< .0001
Acute pain^e	2856 (35.8)	2275 (33.8)	581 (46.7)	< .0001
Major chronic pain^b	768 (9.6)	694 (10.3)	74 (5.9)	< .0001
Mikosz chronic pain^c	915 (11.5)	807 (12.0)	108 (8.7)	< .0006
Chronic overlapping pain conditions^d	467 (5.9)	408 (6.1)	59 (4.7)	0.0757
Injection related infection^f
Skin and soft tissue infection	1248 (15.7)	886 (13.2)	362 (29.1)	< .0001
Septicemia or bacteremia infection	947 (11.9)	751 (11.2)	196 (15.8)	< .0001
Bone, joint, or vascular infection	470 (5.9)	349 (5.2)	121 (9.7)	< .0001
Polysubstance use^g	3422 (42.9)	2760 (41.0)	662 (53.2)	< .0001
Nicotine dependent^h	5106 (64.1)	4206 (62.5)	900 (72.4)	< .0001
Patients with 2+ admissions (N)	3287	2616	671
Major chronic pain^b	309 (9.4)	262 (10.0)	47 (7.0)	0.0171
“Missing” major chronic pain^b	367 (11.2)	278 (10.6)	89 (13.3)	0.0530
Mikosz chronic pain^c	352 (10.7)	287 (11.0)	65 (9.7)	0.3373
“Missing” Mikosz chronic pain^c	392 (11.9)	280 (10.7)	112 (16.7)	0.0001
Chronic Overlapping Pain Conditions^d	173 (5.3)	138 (5.3)	35 (5.2)	0.9512
“Missing” COPC	251 (7.6)	180 (6.9)	71 (10.6)	0.0013

Data are expressed as No. (%) unless otherwise indicated
^aIndicates homelessness, housing insecurity, and problems related to housing and economic circumstances. The full list of associated ICD-10 codes is provided in Additional file 1
^bIndicates central pain syndrome, chronic pain, neoplasm-related pain, and chronic pain syndrome
^cIndicates chronic nonradicular and radicular back pain, chronic neck pain, fibromyalgia, inflammatory joint disorders, irritable bowel syndrome, non-migraine headaches, osteoarthritis and joint cartilage conditions, and periarticular/soft tissue disorders
^dIndicates fibromyalgia, irritable bowel syndrome, interstitial cystitis/bladder pain syndrome, chronic prostatitis, vulvodynia, migraine, chronic tension-type headache, temporomandibular disorder, chronic low back pain, chronic fatigue syndrome, endometriosis with pain
^eIndicates acute pain based on independent coding of admitting diagnoses by two registered nurses
^fIndicates injection related infections separated into skin and soft tissue infections (abscess, cellulitis, necrotizing fasciitis), septicemia and bacteremia, and bone, joint and vascular infections (septic pulmonary embolism, endocarditis, staphylococcal arthritis, osteomyelitis, and intraspinal abscess.)
^gIndicates use of or poisoning from cannabis, cocaine, stimulates, sedatives, hypnotic or anxiolytics, hallucinogens,
^hIndicates current nicotine dependence and a history of nicotine dependence

ISSN: 1477-7517