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. 2022 Jul;131(1):83-92.
doi: 10.1111/bcpt.13741. Epub 2022 May 17.

Short-term mortality following tramadol poisonings in Denmark

Anne Mette Skov Sørensen  1 , Janne Petersen  2   3 , Mikkel Bring Christensen  1   4 , Astrid Blicher Schelde  1 , Jon Traerup Andersen  1   4 , Espen Jimenez Solem  1   2   4 , Tonny Studsgaard Petersen  1   4
Affiliations

Short-term mortality following tramadol poisonings in Denmark

Anne Mette Skov Sørensen et al. Basic Clin Pharmacol Toxicol. 2022 Jul.

Abstract

Tramadol is a commonly used opioid with a potential of addiction and abuse. Using Danish nationwide registers, we aimed to (1) characterise opioid poisonings; (2) assess the 30-day mortality following morphine, oxycodone, and mixed poisonings compared to tramadol poisonings; and (3) assess the development in tramadol poisonings during a 12-year period. Poisonings were identified from 2006 to 2017. A Cox proportional hazards regression model was used to estimate adjusted hazard ratios (aHRs) along with 95% confidence intervals (CIs) for 30-day mortality following morphine, oxycodone or mixed poisonings compared to tramadol poisonings. We identified 7718 opioid poisonings among 6365 patients. The patients with a tramadol poisoning were younger and had less comorbidities than the patients with a morphine, oxycodone or mixed poisoning. Within 30 days, a total of 205 patients died. The 30-day mortality risk was higher following morphine (aHR 3.2, 95% CI 2.0-5.1), oxycodone (aHR 2.1, 95% CI 1.2-3.6) and mixed poisonings (aHR 1.6, 95% CI 1.0-2.7) compared to tramadol poisonings. The annual number of tramadol poisonings increased from 233 in 2006 to 501 in 2013 and declined to 348 in 2017. In conclusion, despite a lower mortality risk compared to other opioid poisonings, physicians should consider the poisoning and abuse risks when prescribing tramadol.

Keywords: epidemiology; intoxications; mortality; opioids; poisonings.

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Conflict of interest statement

Espen Jimenez Solem reports grants from Vertex Pharmaceuticals, Eli Lilly, and Novartis outside the submitted work. The other authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Description of the study cohort (1 January 2006 to 31 December 2017)
FIGURE 2
FIGURE 2
Thirty‐day mortality risk for tramadol, morphine, oxycodone, and mixed poisonings
See this image and copyright information in PMC

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