TY - JOUR
T1 - Discharge prescribing of enteral opioids in opioid naïve patients following non-surgical intensive care
T2 - A retrospective cohort study
AU - Tollinche, Luis E.
AU - Seier, Kenneth P.
AU - Yang, Gloria
AU - Tan, Kay See
AU - Tayban, Yekaterina D.
AU - Pastores, Stephen M.
AU - Yeoh, Cindy B.
AU - Karamchandani, Kunal
N1 - Funding Information:
LET is a grant recipient through Merck Investigator Studies Program (MISP) to fund clinical trial at MSKCC ( NCT03808077 ). LET serves a consultancy and advisory role for Merck & Co. Pharmaceutical Company. LET serves a consultancy and advisory role for GE Healthcare.
Publisher Copyright:
© 2021
PY - 2022/4
Y1 - 2022/4
N2 - Purpose: To estimate the incidence of new prescription of enteral opioids on hospital discharge in opioid naïve, non-surgical, critically ill patients and evaluate the risk factors associated with such occurrence. Methods: Using hospital-wide and ICU databases, we retrospectively identified all patients (≥ 18 years old) who were admitted to the 20-bed adult ICU of Memorial Sloan Kettering Cancer Center (MSKCC) between July 1, 2015 and April 20, 2020. Patients' electronic medical records (EMR) were retrieved and patient demographics, peri-ICU admission data were captured and analyzed. Results: During the study period, a total of 3755 opioid naïve patients were admitted to the ICU and 848 patients met the inclusion criteria. Among these, 346 (40.8%) patients were discharged with a new opioid prescription. Age at ICU admission, preadmission use of benzodiazepine, and antidepressants, a diagnosis of sepsis, and use of mechanical ventilation, antidepressants or, opioid infusion for greater than 4 h during the ICU stay, hospital length of stay (LOS), and days between ICU discharge and hospital discharge were independently associated with increased odds of a new opioid prescription. Conclusions: A significant proportion of opioid naïve non-surgical ICU survivors receive a new opioid prescription on hospital discharge.
AB - Purpose: To estimate the incidence of new prescription of enteral opioids on hospital discharge in opioid naïve, non-surgical, critically ill patients and evaluate the risk factors associated with such occurrence. Methods: Using hospital-wide and ICU databases, we retrospectively identified all patients (≥ 18 years old) who were admitted to the 20-bed adult ICU of Memorial Sloan Kettering Cancer Center (MSKCC) between July 1, 2015 and April 20, 2020. Patients' electronic medical records (EMR) were retrieved and patient demographics, peri-ICU admission data were captured and analyzed. Results: During the study period, a total of 3755 opioid naïve patients were admitted to the ICU and 848 patients met the inclusion criteria. Among these, 346 (40.8%) patients were discharged with a new opioid prescription. Age at ICU admission, preadmission use of benzodiazepine, and antidepressants, a diagnosis of sepsis, and use of mechanical ventilation, antidepressants or, opioid infusion for greater than 4 h during the ICU stay, hospital length of stay (LOS), and days between ICU discharge and hospital discharge were independently associated with increased odds of a new opioid prescription. Conclusions: A significant proportion of opioid naïve non-surgical ICU survivors receive a new opioid prescription on hospital discharge.
KW - Addiction
KW - Analgesics
KW - Cohort studies
KW - Critical Illness
KW - Opioid
KW - Patient discharge
KW - Risk factors
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U2 - 10.1016/j.jcrc.2021.10.021
DO - 10.1016/j.jcrc.2021.10.021
M3 - Article
C2 - 34856489
AN - SCOPUS:85120990717
SN - 0883-9441
VL - 68
SP - 16
EP - 21
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -