Characteristics of prior emergency departments visits associated with subsequent opioid overdose

Objectives: In this study, we aim to identify and discuss the clinical and demographic characteristics of previous emergency department (ED) patient visits, at one of the only two medical centers in Staten Island, the epicenter of the opioid epidemic within Staten Island, who subsequently present to the ED with an opioid overdose. Design: This was a retrospective, observational study of all patients presenting to the emergency ED between July 1, 2010 and December 31, 2015. Setting: The study was conducted at Staten Island University Hospital. The ED has a census of 120,000 patient visits per year. Patients: All adult patients . 18 years of age, with an ICD-9 code consistent with opioid intoxication and a history of intentional or unintentional overdose were included. Main outcome measure: Clinical and demographic characteristics of previous ED patient visits who subsequently presented to the ED with an opioid overdose. Results: One hundred and twenty-four subjects with a median age of 30 years [interquartile range, 24-40] were reviewed. Eighty-seven (70 percent) were males. Fifty-five subjects were admitted, 68 discharged, and one death. Patients were not more likely to present at any specific time of day. The most common past medical history was anxiety (21 percent), depression (20 percent), back pain (15 percent), hypertension (14 percent), and seizure disorder (11 percent). The most common past surgical history was a prior orthopedic procedure (11 percent). Conclusions: This study identified clinical and demographic characteristics of previous ED patient visits who subsequently present to the ED with an opioid overdose. These characteristics will be vital toward an increased understanding of subjects who subsequently experience an opioid overdose.