Opioid use in patients with congestive heart failure

Objective. To understand the relationship between opioid use in patients with congestive heart failure and outcomes, we compared length of stay (LOS), 30-day readmission rates, and 30- and 90-day mortality in patients discharged with a primary diagnosis of congestive heart failure (CHF) who were taking opioids. Design. Retrospective study design. Setting. Patients were seen at a 320-bed academic hospital. Subjects. All patients not awaiting transplant who were discharged with a primary diagnosis of heart failure from January 1, 2011, through December 31, 2014. Methods. Records were reviewed for demographic data, comorbidities, and opioid status at admission or discharge. The association of opioid use (at admission and discharge) with LOS, 30-day readmission, and 30- and 90-day mortality was examined. Results. Six hundred eighty-two patients with a principle diagnosis of heart failure were admitted during the study period, with 168 (24.6%) taking opioids at admission. Opioid use at admission was not significantly associated with 30-day readmission (odds ratio [OR]=1.24, 95% confidence interval [CI]=0.80-1.93), 30-day mortality (hazard ratio [HR]=0.91, 95% CI=0.47-1.78), 90-day mortality (HR=0.95, 95% CI=0.58-1.54), or LOS (parameter estimate=-0.21, 95% CI=20.91 to 0.48). One hundred ninety-three patients (28.3%) were prescribed opioids at discharge. No significant differences were observed between those who were and were not taking opioids at discharge for 30-day readmission (OR=1.10, 95% CI=0.72-1.69) or for 30- or 90-day mortality (HR=0.51, 95% CI=0.24-1.06, and HR=0.67, 95% CI=0.41-1.10, respectively). LOS was slightly shorter for patients not using opioids at discharge than for those who were (mean=3.8 vs 4.6 days, respectively). Conclusions. Opioid use at admission or discharge in patients with CHF did not appear to affect outcomes.