Rates of cocaine use disorder hospitalizations across 17 years were stable

When observed over a 17-year period, the hospitalization and in-hospital mortality of hospitalizations with cocaine use disorder remained stable, according to data published in Journal of Psychiatric Research.

“Contemporary epidemiological data on hospitalizations with cocaine use disorder (CocUD), associated time-trends and hospitalization outcomes are lacking,” Jasvinder A. Singh, MD, of the division of epidemiology at the School of Public Health at the University of Alabama at Birmingham, and colleagues wrote. “Our study objective was to perform a national U.S. epidemiological study of time-trends in hospitalizations with CocUD and associated outcomes of these hospitalizations.”

Using the U.S. National Inpatient Sample (NIS) data from 1998 to 2014, researchers evaluated time-trends in hospitalization rates and the predictors of health care utilization (total hospital charges, discharge destination, length of hospital stay) and in-hospital mortality for CocUD-hospitalization.

Researchers examined the association of patient demographics (age, sex, race/ethnicity, household income), comorbidity (Deyo-Charlson index), insurance payer (Medicare, Medicaid, private, self-pay or other) and hospital characteristics (location/teaching status; hospital bed size; and region) with outcomes with health care utilization and in-hospital mortality for CocUD-hospitalizations using multivariable-adjusted logistic regression analyses.

Between 1998 and 2014, there were 6,454,775 weighted hospitalizations with CocUD in the U.S. (45 years or younger, 65%; male, 63%; Black, 38%). There was no significant change from study periods, 1998-2000 to 2013-2014, in the hospitalization rate, 959 to 973 per 100,000 NIS claims or in-hospital mortality rate, 7.7 to 9.2.

Factors associated with higher health care utilization outcomes and/or in-hospital mortality included older age, male gender, “non-white” race, Deyo-Charlson index score of two or higher, higher income and a larger hospital bed size.

“This national U.S. study provides clear evidence that the rate of hospitalizations with primary or secondary diagnosis of CocUD was stable across 17 years, from study periods, 1998–2000 vs. 2013–14, with a small peak at 2005–2006 and then a decline back to the baseline rates. The hospitalization rate differences between study periods, 1998–2000 and 2013–2014, were not significant, as were the time-trends including all time-points,” Singh and colleagues wrote. “This is reassuring. Given to a knowledge gap regarding time-trends in hospitalizations with CocUD, this study aims to provide contemporary data using a national inpatient database.”

Researchers noted that future studies should focus on the impact of CocUD on population health.