Abstract B013: Sociodemographic differences and inpatient outcomes of opioid use disorder among patients hospitalized for head and neck cancer in the United States
Authors: Akhiwu Ted O , Akpan Inemesit , Imeh Michael , Osazuwa-Peters Nosayaba 
Published: September 2024

Abstract
Background: Opioid use disorder (OUD) is a rising public health concern in the United States. It poses substantial challenges in the management of head and neck cancers (HNC), given the pain associated with the disease. This study examines the sociodemographic differences in OUD among patients hospitalized for HNC in the United States as well as in-patient outcomes of HNC patients with OUD. Methods: We analyzed weighted retrospective data from the 2016 to 2020 National Inpatient Sample database. We included patients 18 years or older with principal discharge diagnoses of HNC with or without secondary diagnoses of OUD using specific ICD-10 codes. OUD was defined as opioid abuse, dependence, poisoning or adverse effects. Baseline sociodemographic and hospital characteristics of HNC patients with or without OUD were compared using χ2 for categorical variables and Student’s t-test for continuous variables. We examined sociodemographic characteristics associated with OUD using multivariable logistic regression models. We assessed three in-patient outcomes including mortality, length of stay and total hospitalization charge (THC) adjusted for inflation. Further we included interaction terms to explore the combined effects of relevant sociodemographic predictors with depression. Results: There were 117,085 hospitalizations for HNC between 2016 and 2020. Among HNC hospitalizations, 3.2% were opioid users and 2.36% had a secondary diagnosis of OUD. The mean age of HNC pts was 63.3 years (SD 0.08). 78.3% were Non-Hispanic White, 11.8% Non-Hispanic Black, 6.7% Hispanic and 3.2% Asians/Pacific Islanders. HNC patients with OUD had higher odds of being female (aOR 1.32; 95% CI 1.09, 1.59) and having more than one comorbidity (aOR 1.088; 95% CI 1.047, 1.132). There were lower odds of OUD with older age &gt;70 years (aOR: 0.25; 95% CI 0.10, 0.59), private insurance (aOR 0.66; 95% CI 0.50, 0.87), higher income quartiles (aOR 0.66; 95% CI 0.50, 0.87) and with hospital regions in the South compared to the North-East United States (aOR 0.57; 95% CI 0.43, 0.74). There was no statistically significant interaction between MDD and gender (aOR 1.27; 95% CI 0.80, 2.04) among patients with HNC and OUD. OUD was not significantly associated with increased mortality in patients hospitalized for HNC (aOR 1.39, 95% CI 0.83, 2.33), however OUD was associated with a greater LOS by 3.6 days (95% CI 2.52, 4.60) and an increased THC of $26,947 (95% CI 13232, 40662). Conclusion: Our study demonstrates significant sociodemographic disparities in the prevalence of OUD among head and neck cancer hospitalizations in the US. Female patients and those with multiple comorbidities had higher odds of OUD. Additionally, OUD was significantly associated with an increased LOS and THC. These findings highlight the need for targeted interventions that address the unique needs of vulnerable populations with OUD and HNC.
Citation Format: Ted O Akhiwu, Inemesit Akpan, Michael Imeh, Nosayaba Osazuwa-Peters. Sociodemographic differences and inpatient outcomes of opioid use disorder among patients hospitalized for head and neck cancer in the United States [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B013.