Article Figures & Tables
Figures
- Figure 1:
Kaplan–Meier plot for crude probability of survival, according to disposition, after visits to the emergency department for overdose-related reasons.
- Figure 2:
Kaplan–Meier plot for probability of survival, according to combined variable of disposition and overdose-related or non-overdose-related
Tables
- Table 1:
Characteristics associated with overdose-related and non-overdose-related visits to emergency departments in British Columbia, 2015–2016
Characteristic Patient group and reason for visit; no. (%) of patients* All patients Discharged Left against medical advice Overdose
n = 3593Non-overdose
n = 216 453Overdose
n = 3133Non-overdose
n = 187 932Overdose
n = 150Non-overdose
n = 7960Index visits to ED Health authority Interior Health 73 (2.0) 23 432 (10.8) 66 (2.1) 20 028 (10.7) 2 (1.3) 765 (9.6) Fraser Health 1900 (52.9) 93 487 (43.2) 1652 (52.7) 81 882 (43.6) 42 (28.0) 3694 (46.4) Vancouver Coastal Health 1407 (39.2) 51 274 (23.7) 1234 (39.4) 44 539 (23.7) 96 (64.0) 1903 (23.9) Island Health 67 (1.9) 38 952 (18.0) 60 (1.9) 33 638 (17.9) 1 (0.7) 1200 (15.1) Northern Health 137 (3.8) 8578 (4.0) 113 (3.6) 7208 (3.8) 8 (5.3) 371 (4.7) Unknown 9 (0.3) 730 (0.3) 8 (0.3) 637 (0.3) 1 (0.7) 27 (0.3) Arrival by ambulance 2966 (82.5) 33 062 (15.3) 2585 (82.5) 23 525 (12.5) 139 (92.7) 1261 (15.8) Canadian Triage and Acuity Scale 1 (resuscitation) 128 (3.6) 1429 (0.7) 73 (2.3) 425 (0.2) 5 (3.3) 7 (0.1) 2 (emergent) 1096 (30.5) 31 827 (14.7) 888 (28.3) 23 023 (12.3) 35 (23.3) 426 (5.4) 3 (urgent) 2147 (59.8) 100 094 (46.2) 1968 (62.8) 86 752 (46.2) 103 (68.7) 3393 (42.6) 4 (less urgent) 189 (5.3) 73 596 (34.0) 174 (5.6) 69 851 (37.2) 6 (4.0) 2679 (33.7) 5 (nonurgent) 19 (0.5) 5415 (2.5) 19 (0.6) 4997 (2.7) 0 (0.0) 353 (4.4) Unknown 14 (0.4) 4092 (1.9) 11 (0.4) 2884 (1.5) 1 (0.7) 1102 (13.8) Visit length of stay, h, median (IQR) 3.5 (2.2–5.9) 2.8 (1.7–4.5) 3.5 (2.2–5.8) 2.8 (1.7–4.3) 3.5 (2.2–5.8) 2.8 (1.7–4.3) Disposition after index visit Discharged 3133 (87.2) 187 932 (86.8) – – – – Left against medical advice 150 (4.2) 7960 (3.7) – – – – Admitted or transferred 310 (8.6) 20 561 (9.5) – – – – Patients Sex, female 1098 (30.6) 108 524 (50.1) 939 (30.0) 95 837 (51.0) 33 (22.0) 3724 (46.8) Age, yr, median (IQR) 35.0 (27.0–46.0) 41.0 (28.0–56.0) 35.0 (27.0–46.0) 42.0 (28.0–56.0) 35.0 (27.0–46.0) 42.0 (28.0–56.0) Age group, yr 14–35 1836 (51.1) 83 451 (38.6) 1618 (51.6) 75 016 (39.9) 74 (49.3) 3815 (47.9) 36–55 1458 (40.6) 72 846 (33.7) 1268 (40.5) 64 063 (34.1) 63 (42.0) 2732 (34.3) 56–74 299 (8.3) 60 156 (27.8) 247 (7.9) 48 853 (26.0) 13 (8.7) 1413 (17.8) Material deprivation quintile† 1 (most deprived) 391 (16.6) 37 873 (19.6) 331 (16.3) 33 318 (19.7) 21 (25.6) 1297 (18.7) 2 289 (12.3) 37 265 (19.3) 238 (11.7) 32 714 (19.4) 11 (13.4) 1263 (18.3) 3 347 (14.7) 36 920 (19.1) 301 (14.8) 32 212 (19.1) 12 (14.6) 1265 (18.3) 4 445 (18.9) 38 403 (19.9) 392 (19.3) 33 381 (19.8) 12 (14.6) 1375 (19.9) 5 (least deprived) 883 (37.5) 42 981 (22.2) 771 (37.9) 37 144 (22.0) 26 (31.7) 1719 (24.8) Elixhauser index with mental health 0 2606 (72.5) 197 785 (91.4) 2379 (75.9) 179 940 (95.7) 128 (85.3) 7586 (95.3) 1 451 (12.6) 10 313 (4.8) 339 (10.8) 4920 (2.6) 10 (6.7) 234 (2.9) ≥ 2 536 (14.9) 8355 (3.9) 415 (13.2) 3072 (1.6) 12 (8.0) 140 (1.8) Elixhauser index without mental health 0 3287 (91.5) 201 901 (93.3) 2909 (92.9) 181 496 (96.6) 144 (96.0) 7748 (97.3) 1 187 (5.2) 8478 (3.9) 145 (4.6) 4251 (2.3) 2 (1.3) 145 (1.8) ≥ 2 119 (3.3) 6074 (2.8) 79 (2.5) 2185 (1.2) 4 (2.7) 67 (0.8) Psychiatric comorbidities Anxiety 561 (15.6) 11 032 (5.1) 478 (15.3) 9035 (4.8) 10 (6.7) 501 (6.3) Depression 611 (17.0) 13 113 (6.1) 499 (15.9) 10 379 (5.5) 18 (12.0) 590 (7.4) Schizophrenia 364 (10.1) 2928 (1.4) 319 (10.2) 1658 (0.9) 12 (8.0) 135 (1.7) Personality disorders 195 (5.4) 992 (0.5) 161 (5.1) 582 (0.3) 3 (2.0) 45 (0.6) ≥ 1 prescription medication in 365 d before index visit Opioids for analgesia 1232 (34.3) 47 502 (21.9) 1048 (33.5) 40 325 (21.5) 54 (36.0) 1666 (20.9) Opioid agonist therapy 1375 (38.3) 3985 (1.8) 1215 (38.8) 2997 (1.6) 73 (48.7) 411 (5.2) Benzodiazepines and z-drugs‡ 1094 (30.4) 32 867 (15.2) 934 (29.8) 26 845 (14.3) 31 (20.7) 1280 (16.1) Antidepressant and antipsychotic medications 1976 (55.0) 44 193 (20.4) 1702 (54.3) 35 988 (19.1) 74 (49.3) 1920 (24.1) Incarceration in 365 d before index visit 788 (21.9) 2422 (1.1) 708 (22.6) 1887 (1.0) 33 (22.0) 230 (2.9) Health care encounters in 365 d before index visit, median (IQR) Hospitalization 0.0 (0.0–1.0) 0.0 (0.0–0.0) 0.0 (0.0–1.0) 0.0 (0.0–0.0) 0.0 (0.0–1.0) 0.0 (0.0–0.0) Ambulance 1.0 (0.0–1.0) 0.0 (0.0–0.0) 1.0 (0.0–1.0) 0.0 (0.0–0.0) 1.0 (0.0–1.0) 0.0 (0.0–0.0) Physician visits§ 15.0 (5.0–39.0) 8.0 (3.0–15.0) 14.0 (5.0–38.0) 7.0 (3.0–14.0) 14.0 (5.0–38.0) 7.0 (3.0–14.0) No. of physicians§ 10.0 (5.0–18.0) 7.0 (3.0–11.0) 10.0 (4.0–18.0) 6.0 (3.0–11.0) 10.0 (4.0–18.0) 6.0 (3.0–11.0) ED visits 2.0 (0.0–5.0) 0.0 (0.0–0.0) 2.0 (0.0–5.0) 0.0 (0.0–0.0) 2.0 (0.0–5.0) 0.0 (0.0–0.0) Note: ED = emergency department, IQR = interquartile range.
↵* Except where indicated otherwise.
↵† Data for material deprivation were missing for the following numbers of patients: 1238 of all patients with an overdose-related visit, 23 011 of all patients with a non-overdose-related visit, 1100 of patients who were discharged after an overdose-related visit, 19 163 of patients who were discharged after a non-overdose-related visit, 68 of patients who left against medical advice after an overdose-related visit and 1041 of patients who left against medical advice after a non-overdose-related visit.
↵‡ For example, zolpidem and zopiclone.
↵§ Community or outpatient.
- Table 2:
Crude mortality proportions among persons with overdose-related and non-overdose-related visits to the emergency department, overall and by disposition status
Disposition and time frame, mo Type of visit; % of patients who died (95% CI) Overdose-related Non-overdose-related Overall (any disposition) 1 0.8 (0.6–1.2) 0.4 (0.4–0.4) 3 1.8 (1.4–2.3) 0.7 (0.7–0.8) 6 3.5 (2.9–4.1) 1.1 (1.1–1.1) 12 5.4 (4.7–6.2) 1.7 (1.6–1.8) Not admitted* 1 0.7 (0.4–1.0) 0.1 (0.1–0.1) 3 1.6 (1.3–2.1) 0.3 (0.3–0.3) 6 3.4 (2.8–4.0) 0.6 (0.5–0.6) 12 5.3 (4.6–6.1) 1.0 (1.0–1.1) Discharged to home or place of residence 1 0.6 (0.4–1.0) 0.1 (0.1–0.1) 3 1.6 (1.2–2.1) 0.3 (0.3–0.3) 6 3.3 (2.7–3.9) 0.6 (0.5–0.6) 12 5.1 (4.4–6.0) 1.0 (1.0–1.1) Left against medical advice 1 2.0 (0.7–6.1) 0.2 (0.1–0.3) 3 2.0 (0.7–6.1) 0.4 (0.3–0.6) 6 5.3 (2.7–10.4) 0.7 (0.5–0.9) 12 8.0 (4.6–13.7) 1.3 (1.1–1.6) Admitted or transferred 1 2.3 (1.1–4.7) 2.9 (2.7–3.2) 3 3.6 (2.0–6.3) 4.6 (4.3–4.9) 6 4.8 (3.0–7.9) 6.1 (5.8–6.4) 12 6.5 (4.2–9.8) 8.2 (7.8–8.6) Note: ED = emergency department, CI = confidence interval.
↵* “Not admitted” is a combined category for those who were discharged and those who left against medical advice.
- Table 3:
Adjusted and unadjusted 12-month mortality hazard ratios for persons with overdose-related versus non-overdose-related visits to the emergency department who were either discharged with approval or left against medical advice
Model Type of model; hazard ratio (95% CI) Adjusted* Unadjusted Type of visit and disposition Non-overdose-related and discharged 1.0 (Ref.) 1.0 (Ref.) Non-overdose-related and left against medical advice 1.4 (1.2–1.7) 8.3 (4.7–14.6) Overdose-related and discharged 3.5 (3.0–4.2) 1.3 (1.0–1.6) Overdose-related and left against medical advice 7.1 (4.0–12.5) 5.2 (4.5–6.1) Additional contrasts Overdose-related v. non-overdose-related visits among those who left against medical advice 5.0 (2.7–9.1) 6.5 (3.6–11.8) Left against medical advice v. discharged among those with overdose-related visits 2.0 (1.1–3.6) 1.5 (0.9–2.9) Age group, yr 14–35 1.0 (Ref.) 1.0 (Ref.) 36–55 2.0 (1.7–2.3) 2.1 (1.8–2.4) 56–74 4.5 (4.1–5.1) 5.2 (4.7–5.9) Sex Male v. female 1.7 (1.6–1.9) 1.9 (1.7–2.1) Elixhauser index with mental health 0 1.0 (Ref.) 1.0 (Ref.) 1 3.8 (3.3–4.3) 5.6 (4.9–6.5) ≥ 2 8.0 (7.1–9.0) 10.9 (9.4–12.6) Note: CI = confidence interval, Ref. = reference group.
↵* Adjusted for age, sex, comorbidity and disposition (discharged or left against medical advice).
In this issue
Article tools
Related Articles
Cited By...
- No citing articles found.