Morbidity, mortality, and health outcomes following emergency department visits for fentanyl-related overdoses: A retrospective cohort study.

Background: Overdose (OD)-related mortality has been extensively studied; however, less is known about OD-related morbidity beyond neurocognitive impairments (NCI). The purpose of this study is to systematically describe morbidity, mortality, and health outcomes following a fentanyl-related OD treated in the emergency department (ED). Methods: A retrospective cohort study (n = 205) was conducted using electronic medical record (EMR) data of patients who presented to an ED for a suspected or confirmed fentanyl-related OD within a rural health system that includes 25 hospitals across 4 states. Eligible events occurred between November 1, 2021 and October 31, 2022. Results: A third (32 %) of patients were discharged the same day, 6 % were hospitalized for 10 +  days, 34 % were transferred to the intensive care unit (ICU) and 8 % died during their hospitalization. Twenty-three patients had ongoing health conditions that necessitated transfer to another inpatient hospital or a skilled nursing facility. Among the 633 diagnoses recorded, the majority (64 %) were categorized as related to the OD and specifically 20 % of patients had amnesia or memory loss. Diagnoses were also categorized as mental health (17 %) and medical conditions (11 %). A third of patients were administered naloxone in the hospital and other medication administered included gastrointestinal agents, central nervous system agents and analgesics. Conclusion: Patients treated in the ED for a non-fatal OD had significant hospital service utilization and had complex morbidity suggesting the need for coordinated aftercare, as well as screening for NCI.