The following is a summary of the “Patterns of mortality risk among patients with substance use disorder: an opportunity for proactive patient safety?” published in the December 2022 issue of Psychiatry by Svensson et al.

When compared to the general population, patients with substance use disorder (SUD) have a higher mortality rate. This research aims to understand better the factors contributing to the high mortality rates of SUD patients seeking care at an emergency room dedicated to SUD and to determine whether this information can be used to better screen for potential danger and improve patient outcomes. Between 2010 and 2020, medical record data on SUD emergency room visits were collected. Information collected included sex, age, SUD diagnosis, and time of death. 

To compare ordinal variables, researchers employed the Kruskal-Wallis rank sum test, and to quantify the disparity in mortality risk; they turned to the risk ratio.  All statistical analyses were performed on a two-tailed basis, with a 95% confidence interval and a p-value of 0.05 or less set as the threshold for statistical significance. Male patients in the study group had a mortality risk that was 1.41-1.59 times that of female patients. During the study period, the overall mortality rate was 0.14 %. Although 73.7% of the group had a confirmed alcohol use disorder, having a condition with opioids or sedative hypnotics was related to the highest death rates, with a 1.29-1.52 and 1.47-1.74 greater mortality risk, respectively, than those without such diagnoses.

This research shows that gender, diagnosis type, number of diagnoses, and frequency of SUD emergency department visits can be used to predict mortality risk. Patient safety could be improved with the use of electronic medical records -integrated decision support tool by using information about patients’ visit patterns and potential mortality risks. An opportunity for an adaptive patient safety system can be found in a better system for early detection of elevated mortality risk.

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-04437-6