Table 2. Clinical Characteristics of Sublingual Buprenorphine Induction for Opioid Use Disorder During Emergency Department Visits.
| Characteristic | Total buprenorphine dose sublingual | P valuea | |||||
|---|---|---|---|---|---|---|---|
| 2-6 mg (n = 55) | 8 mg (n = 136) | 10-12 mg (n = 22) | 16 mg (n = 106) | 20-24 mg (n = 122) | ≥28 mg (n = 138) | ||
| Systolic blood pressure, median (IQR), mm Hg | |||||||
| At triage | 133 (120-150) | 132 (120-150) | 132 (110-140) | 128 (120-140) | 128 (120-150) | 130 (120-140) | .75 |
| Maximum | 135 (130-160) | 140 (130-160) | 140 (130-150) | 133 (120-150) | 134 (120-150) | 142 (120-160) | .48 |
| Minimum | 118 (110-130) | 117 (110-130) | 103 (97-130) | 116 (100-130) | 116 (110-130) | 121 (110-140) | .83 |
| Respiratory rate, median (IQR), breaths/min | |||||||
| At triage | 18 (16-18) | 18 (16-18) | 18 (16-18) | 18 (16-18) | 18 (17-18) | 18 (17-18) | .26 |
| Maximum | 18 (18-18) | 18 (18-20) | 18 (17-18) | 18 (18-20) | 18 (18-20) | 18 (18-20) | .23 |
| Minimum | 16 (15-17) | 16 (16-18) | 16 (16-17) | 16 (16-18) | 16 (16-18) | 16 (16-18) | .08 |
| Heart rate, median (IQR), beats/min | |||||||
| At triage | 84 (70-98) | 89.5 (78-100) | 87 (81-94) | 83.5 (75-95) | 88 (80-100) | 87 (79-99) | .16 |
| Maximum | 87 (77-100) | 92.5 (82-100) | 88 (76-98) | 90 (80-100) | 95.5 (87-100) | 96.5 (81-100) | .73 |
| Minimum | 71 (63-80) | 76 (68-85) | 64 (60-84) | 77 (66-86) | 80 (70-89) | 76 (71-88) | .26 |
| Temperature, °F | 98 (97-98) | 97.8 (97-98) | 97.6 (97-98) | 97.5 (97-98) | 97.9 (97-98) | 97.8 (97-98) | .24 |
| Oxygen saturation, median (IQR), % | |||||||
| At triage | 99 (98-100) | 99 (98-100) | 98 (97-100) | 99 (98-100) | 99 (98-100) | 99 (98-100) | .29 |
| Maximum | 100 (99-100) | 99 (99-100) | 100 (98-100) | 99 (98-100) | 99 (98-100) | 99 (99-100) | .13 |
| Minimum | 97 (96-99) | 98 (97-99) | 96 (96-96) | 97.5 (96-98) | 97.5 (96-99) | 97.5 (96-99) | .25 |
| Supplemental oxygen, patients, No. (%) | 6 (11) | 3 (2.2)b | 1 (4.5) | 4 (3.8) | 2 (1.6)b | 1 (0.72)b | .01 |
| Chronic obstructive pulmonary disease diagnosis, patients, No. (%) | 17 (2.9) | 2 (3.6) | 3 (2.2) | 1 (4.5) | 4 (3.8) | 2 (1.6) | .76 |
| Emergency Severity Index, patients, No. (%) | |||||||
| 1 | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | .10 |
| 2 | 7 (13) | 9 (6.6) | 0 (0) | 5 (4.7) | 4 (3.3) | 5 (3.6) | |
| 3 | 24 (44) | 38 (28) | 5 (23) | 31 (29) | 38 (31) | 33 (24) | |
| 4 | 15 (27) | 63 (46) | 11 (50) | 46 (43) | 64 (52) | 81 (59) | |
| 5 | 9 (16) | 26 (19) | 6 (27) | 24 (23) | 16 (13) | 19 (14) | |
| Length of stay, median (IQR), h | 3.5 (2.4-5.8) | 2.6 (1.7-4.4)b | 2.6 (2.1-3.7) | 2.1 (1.5-3.5)b,c | 2.2 (1.4-3.3)b | 2.3 (1.7-3.6)b | .002 |
| Clinician type, No. (%) | |||||||
| Advance practice provider | 22 (40) | 72 (53) | 15 (68)b | 64 (60)b | 87 (71)b,c | 99 (72)b,c | <.001d |
| Medical doctor | 33 (60) | 64 (47) | 7 (32) | 42 (40) | 35 (29) | 39 (28) | |
| Adverse events, No. (%) | |||||||
| Precipitated withdrawal | 0 | 4 (2.9) | 0 | 0 | 0 | 1 (0.7) | .20 |
| Hospitalization | 5 (9.1) | 4 (2.9) | 1 (4.5) | 3 (2.8) | 8 (6.6) | 4 (2.9) | .26 |
| Return to ED within 24 h | 2 (3.6) | 10 (7.4) | 3 (14.0) | 9 (8.5) | 6 (4.9) | 15 (11.0) | .32 |
| Time to return to ED within 24 h, median (IQR), h | 13.8 (12-16) | 11.4 (5.9-14) | 17.8 (11-20) | .4 (6.5-23) | 15.1 (13-18) | 18.4 (14-22) | .52 |
Abbreviations: ED, emergency department; IQR, interquartile range.
SI conversion factor: To convert degrees Fahrenheit to degrees Celsius, subtract 32 and multiply by 0.556.
a
P values are for any differences among categories of total buprenorphine sublingual dose. After significant omnibus test, all pairwise comparisons were performed. Results of pairwise dose category comparisons that are significant are marked by a footnote indicating which column was different.
b
P < .05 for pairwise comparison to 2- to 6-mg total dose.
c
P < .05 for pairwise comparison to 8-mg total dose.
d
P value for any difference in the proportions of encounters that were by advance practice practitioners across the total buprenorphine dose categories.