UMEM Educational Pearls

Category: Toxicology

Title: Risk of fatality after ED visit for non fatal opioid overdose

Keywords: non-fatal opioid overdose, risk of fatality (PubMed Search)

Posted: 1/16/2020 by Hong Kim, MD
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Many patients are treated in the emergency room for non-fatal opioid overdose. However, it is unknown what proportion of these patient population experience subsequent fatality after their ED visit. 

A recent study investigated the 1-year mortality rate among Massachusetts ED patients who were treated and discharged from ED for non-fatal opioid overdose.

Results

  • 11,557 patients were identified between July 1, 2011 and September 30, 2015.
  • There were 635 fatalities (5.5%) within 1 year in this cohort.
    • Of these, 428 (67.4%) died due to opioid overdose

Of those who died, 

  • 130 (20.5%) died within 1 month
  • 29 (4.6%) died within 2 days.

Manner of death

  • Natural causes: 121 (19.1%)
  • Accidental: 460 (72.4%)
  • Suicide: 13 (2.0%)
  • Other/pending investigation: 41 (6.5%)

Place of death

  • Hospital: 310 (48.8%)
  • Residence: 146 (23.0%)
  • Other/unknown/nursing home: 179 (28.2%)

Conclusion

  • There is high rate of fatality within 1 month (20.5%) after non-fatal opioid overdose ED visits.
  • Subsequent fatal opioid overdose was observed in 428 (67.4%) of the cohort.

References

Weiner SG et al. One-year mortality of patients after emergency department treatment for nonfatal opioid overdose. Ann Emerg Med 2020 https://doi.org/10.1016/j.annemergmed.2019.04.020