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Preadmission chronic opioid usage and its association with 90-day mortality in critically ill patients: a

Tak Kyu Oh1, In-Ae Song1, Jae Ho Lee2

  • 1Department of Anesthesiology and Pain Medicine, South Korea.

British Journal of Anaesthesia
|April 22, 2019
PubMed

Insights

Chronic opioid use in critically ill patients is linked to a higher risk of 90-day mortality. This association is particularly notable in cancer patients and those without chronic kidney disease.

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Epidemiology

Background:

  • Investigating the impact of chronic opioid use on patient outcomes in intensive care units (ICUs).
  • Understanding the association between long-term opioid therapy and mortality in critically ill populations.

Purpose of the Study:

  • To determine the relationship between chronic opioid consumption and 90-day mortality in adult patients admitted to the ICU.
  • To compare mortality rates between chronic opioid users and opioid-naïve patients in critical care settings.

Main Methods:

  • Retrospective cohort study of 18,409 adult ICU admissions from 2012-2017.
  • Defined chronic opioid users as those on regular opioid therapy for >4 weeks pre-ICU admission.
  • Utilized propensity matching and multivariable logistic regression for analysis.

Main Results:

  • Chronic opioid users (4.1% of cohort) had significantly higher 90-day mortality (OR=1.90-2.20, P<0.001).
  • Increased mortality risk was observed in cancer patients and those without chronic kidney disease (CKD).
  • No significant association found in non-cancer patients or patients with CKD.

Conclusions:

  • Chronic opioid use is independently associated with increased 90-day mortality in critically ill adult patients.
  • The heightened risk of mortality is more pronounced in specific subgroups, including cancer patients and non-CKD patients.
Abstract

Keywords:
analgesicscritical careintensive care unitsmortalityneoplasmsopioidoutcomesepsis

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