Opioid Use After Intensive Care: A Nationwide Cohort Study

Area of Science:

• Critical Care Medicine
• Pharmacology
• Public Health

Background:

• Opioid use is a significant concern in post-intensive care unit (ICU) patient management.
• Understanding long-term opioid consumption patterns and associated risks after critical illness is essential.

Purpose of the Study:

• To characterize opioid use following ICU admission.
• To identify predictors of chronic opioid use after critical care.
• To assess the association between chronic opioid use and mortality risk.

Main Methods:

• Retrospective cohort study of 204,402 adult patients admitted to ICUs in Sweden (2010-2018).
• Analysis of opioid consumption and mortality up to 24 months post-ICU discharge.
• Identification of factors associated with chronic opioid use.

Main Results:

• 22,138 patients (10.8%) developed chronic opioid use.
• Chronic opioid use was linked to higher age, female sex, comorbidities, pre-ICU opioid use, and longer ICU stays (>2 days).
• Chronic opioid users had a 1.7-fold increased adjusted hazard ratio for death (6-18 months post-admission).

Conclusions:

• Opioid consumption remains elevated 24 months post-ICU admission, even without clear long-term treatment indications.
• Chronic opioid use following critical care is associated with increased mortality.
• Strategies to prevent opioid misuse are vital for improving long-term outcomes in critical care survivors.