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. 2022 Apr:68:16-21.
doi: 10.1016/j.jcrc.2021.10.021. Epub 2021 Nov 29.

Discharge prescribing of enteral opioids in opioid naïve patients following non-surgical intensive care: A retrospective cohort study

Luis E Tollinche  1 , Kenneth P Seier  2 , Gloria Yang  3 , Kay See Tan  4 , Yekaterina D Tayban  5 , Stephen M Pastores  6 , Cindy B Yeoh  7 , Kunal Karamchandani  8
Affiliations

Discharge prescribing of enteral opioids in opioid naïve patients following non-surgical intensive care: A retrospective cohort study

Luis E Tollinche et al. J Crit Care. 2022 Apr.

Abstract

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.

Keywords: Addiction; Analgesics; Cohort studies; Critical Illness; Opioid; Patient discharge; Risk factors.

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Conflict of interest statement

Declaration of competing interest 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.

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