Nationwide Study: Sepsis Present in 1 in 3 Patients With OUD Who Died in the Hospital


Patients who had OUD and sepsis were found to be younger and healthier than patients without OUD.

Editor's note: Updated 2/25/2020 at 11:05 AM EST

People with opioid use disorder (OUD) are more likely to acquire fungal and bacterial infections, including skin and skin structure, soft tissue, bones/joint, and bloodstream infections. These infections are also likely to occur individuals who use injection drugs.

According to new research presented at the 49th Critical Care Congress, people with OUD are more likely to be hospitalized for sepsis and die if they are young and otherwise healthy.

“Sepsis is an increasing problem among people with OUD, especially those who are young and healthy,” Mohammad Alrawashdeh, MSN, PhD, postdoctoral research fellow in therapeutics research and infectious disease epidemiology at Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, said in a statement. “People with OUD who inject the drugs are at risk for a serious and potentially deadly infection if they use non-sterile needles.”

For their research, the investigators analyzed more than 6.7 million hospital records between 2009 and 2015. The team discovered that 375,479 patients had sepsis (5.6%), 164,891 had OUD (2.5%), and 11,861 (.2%) had both.

The investigators determined that over the 7-year period, 1 in 14 hospitalized patients with OUD had sepsis. Additionally, sepsis was present in 1 in 3 patients with OUD who died in the hospital.

Over the study period the percentage of people with sepsis who also had OUD increased from 3% in 2009 to 4.2% in 2015.

Those individuals with OUD were also more likely to have sepsis as 7.2% of patients with OUD had sepsis versus 5.6% of patients who did not have OUD.

Among all patients with sepsis, those who also had OUD were younger and healthier. The average age of a patient with OUD and sepsis was 53 years. In comparison the average age for a patient with sepsis was 67 years. Additionally, patients with OUD and sepsis had an Elixhauser score of 7.3 vs 12.6, indicating they had fewer other health issues such as high blood pressure or diabetes.

The study team noted that patients with sepsis and OUD were also more likely to have endocarditis (3.9% vs 0.7%), require mechanical ventilation (32.6% vs 24%), and were more likely to stay in the intensive care unit longer (7.9 days vs 7 days on average).

Overall, the study team found that patients with OUD accounted for 2.1% of deaths among sepsis hospitalization, but 3.3% of healthy patients and 7.1% of those younger than 50 years of age.

Based on these findings the investigators concluded that OUD contributed disproportionately to sepsis-associated deaths in younger and healthier patients.

“In combatting the opioid crisis, public health officials should also raise awareness with both patients and providers about the risk of death due to sepsis,” Alrawashdeh concluded.

The abstract, Epidemiology, outcomes and trends of sepsis in patients with opioid use disorders in US hospitals, was presented in a late breaking session at the 49th Critical Care Congress in Orlando Florida.

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