ArticleJournal of community hospital internal medicine perspectives2026
A Comparative Analysis of Opioid Overdose Hospitalizations Pre- and Post-Pandemic: Insights from the National Inpatient Sample Database.
Article in Journal of community hospital internal medicine perspectives, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The COVID-19 pandemic disrupted healthcare systems, affecting opioid overdose-related hospitalizations. National data examining how demographic and clinical outcomes evolved during this period, particularly by overdose intent, remain limited. Methods: Using the National Inpatient Sample (2018-2021), we identified adult hospitalizations for opioid overdose using ICD-10 codes and categorized cases as intentional, unintentional, or unspecified. Patients were grouped into pre-COVID (2018-2019) and post-COVID (2020-2021) cohorts. Multivariable logistic and linear regression models adjusted for patient- and hospital-level factors evaluated demographic differences, complications, and outcomes. Results: Among 293,810 hospitalizations, intentional overdoses decreased over time, while unintentional overdoses remained predominant. Post-COVID hospitalizations had higher odds of, sudden cardiac arrest (5.53% vs 4.52%; aOR 1.18, 95% CI 1.09-1.27), vasopressor use (aOR 1.12, 95% CI 1.01-1.24), and cardiac dysrhythmias (aOR 1.08, 95% CI 1.02-1.14), with no mortality difference (aOR 1.00, 95% CI 0.92-1.08).Intentional overdoses were more common among younger females and associated with better clinical outcomes. Compared with unintentional overdoses, intentional cases had lower odds of in-hospital mortality (1.86% vs 4.90%; aOR 0.47, 95% CI 0.40-0.55), sudden cardiac arrest (aOR 0.26, 95% CI 0.22-0.31), invasive ventilation (aOR 0.80, 95% CI 0.76-0.85), and anoxic brain injury (aOR 0.41, 95% CI 0.35-0.47). Conclusions: Despite a decline in opioid overdose-related hospitalizations, unintentional overdoses remained the dominant and more severe presentation. The increase in post-COVID complications suggests a shift toward greater clinical acuity, placing additional strain on inpatient healthcare resources.
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