Work

The impact of co-occurring opioid and stimulant use disorders on unplanned readmissions among patients hospitalized with bacterial infections

Year: 2026

Type: article

Abstract: Opioid and stimulant use disorders (OUD and StUD) are major drivers of injection drug use (IDU)-related bacterial infections requiring hospitalization and may increase readmission risk. However, the independent and combined effects of these factors on short-term readmission risk remain unclear. We examined the association between OUD and/or StUD and unplanned 7-day and 30-day all-cause readmissions among patients hospitalized with IDU-related bacterial infections. We conducted a retrospective cohort study utilizing the 2022 Healthcare Cost and Utilization Project Nationwide Readmission Database (NRD), applying survey weights to generate national estimates. The study included adults hospitalized with a primary diagnosis of skin and soft tissue infections, osteomyelitis, infective endocarditis, or central nervous system abscess. Exposure groups were neither disorder, OUD only, StUD only, and co-occurring OUD and StUD, identified using ICD-10-CM codes. Primary outcomes were unplanned all-cause readmission within 7 days and 30 days of discharge. Among 392,984 weighted index admissions, the mean age was 58.8 years, 57.1% were male, and 46.9% had Medicare coverage. Overall, 4.5% involved OUD only, 3.9% StUD only, and 2.4% co-occurring disorders. Unplanned readmission rates were 4.3% (7-day) and 12.48% (30-day). After adjustment, OUD and/or StUD were associated with higher odds of 7-day and 30-day readmission compared with neither disorder. Although statistically insignificant, patients with co-occurring disorders had higher odds of readmission than those with OUD only. OUD and/or StUD were associated with an increased risk of short-term unplanned readmission after IDU-related bacterial infections. These findings may highlight the potential value of integrating addiction treatment into inpatient infection care.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-026-14321-3