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Association of Patient Sex and Pregnancy Status With Naloxone Administration During Emergency Department Visits
- Source :
- Obstet Gynecol
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Objective To evaluate the association of sex and pregnancy status with rates of naloxone administration during opioid overdose-related emergency department (ED) visits by using the Nationwide Emergency Department Sample. Methods A retrospective cohort study was conducted using the Nationwide Emergency Department Sample 2016 and 2017 data sets. Eligible records included men and women, 15-49 years of age, with an opioid overdose-related ED visit; records for women were stratified by pregnancy status (International Classification of Diseases, Tenth Revision O codes). A multivariable logistic regression model was used to assess the primary outcome of naloxone administration (Current Procedural Terminology code: J2310). Secondary outcomes included subsequent admission and mortality. A subgroup analysis compared pregnant women who did receive naloxone compared with those who did not receive naloxone. Results Records from 443,714 men, 304,364 nonpregnant women, and 25,056 pregnant women were included. Nonpregnant women had lower odds for naloxone administration (1.70% vs 2.10%; adjusted odds ratio [aOR] 0.86 [95% CI 0.83-0.89]) and mortality (2.21% vs 2.99%; aOR 0.71 [95% CI 0.69-0.73]) but higher odds of subsequent admission (30.22% vs 27.18%; aOR 1.04 [95% CI 1.03-1.06]) compared with men. Pregnant women had lower odds for naloxone administration (0.27% vs 1.70%; aOR 0.16 [95% CI 0.13-0.21]) and mortality (0.41% vs 2.21%; aOR 0.28 [95% CI 0.23-0.35]) but higher odds of subsequent admission (40.50% vs 30.22%; aOR 2.04 [95% CI 2.00-2.10]) compared with nonpregnant women. Pregnant women who received naloxone had higher odds of mortality (14% vs 0.39%; aOR 6.30 [95% CI 2.11-18.78]) compared with pregnant women who did not receive naloxone. Pregnant women who did not receive naloxone were more likely to have Medicaid as their expected insurance payer, be in the lowest quartile of median household income for residence ZIP codes, and have a concurrent mental health diagnosis compared with pregnant women who did receive naloxone. Conclusion Reproductive-aged women who are nonpregnant and pregnant were less likely to receive naloxone during opioid overdose-related ED visits compared with reproductive-aged men. Naloxone administration for reproductive-aged women should be prioritized in the efforts to reduce opioid- and pregnancy-related morbidity and mortality in the United States.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Narcotic Antagonists
Logistic regression
Article
Cohort Studies
Young Adult
03 medical and health sciences
Sex Factors
0302 clinical medicine
Pregnancy
Naloxone
medicine
Humans
030212 general & internal medicine
Healthcare Disparities
Retrospective Studies
030219 obstetrics & reproductive medicine
Obstetrics
business.industry
Obstetrics and Gynecology
Retrospective cohort study
Odds ratio
Emergency department
Middle Aged
Opioid-Related Disorders
United States
Opioid
Quartile
Current Procedural Terminology
Female
Pregnant Women
Emergency Service, Hospital
business
medicine.drug
Subjects
Details
- ISSN :
- 00297844
- Volume :
- 137
- Database :
- OpenAIRE
- Journal :
- Obstetrics & Gynecology
- Accession number :
- edsair.doi.dedup.....bb5cb19f10e4302bdf87974c5cfdb0ed