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

• Published in: Journal of critical care Vol. 68; pp. 16 - 21
• Main Authors: Tollinche, Luis E., Seier, Kenneth P., Yang, Gloria, Tan, Kay See, Tayban, Yekaterina D., Pastores, Stephen M., Yeoh, Cindy B., Karamchandani, Kunal
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2022; Elsevier Limited
• Subjects: Addiction; Adolescent; Adult; Analgesics; Analgesics, Opioid - therapeutic use; Benzodiazepines; Cancer; Cohort analysis; Cohort studies; Critical Illness; Hospitalization; Humans; Intensive care; Intensive Care Units; Narcotics; Opioid; Ostomy; Patient Discharge; Patients; Psychotropic drugs; Respiration, Artificial; Retrospective Studies; Risk factors; Sensitivity analysis; Sepsis; Ventilators; United States > US; Analgesics; Addiction; Cohort studies; Opioid; Critical Illness; Patient discharge; Risk factors
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2021.10.021

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. 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. 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. A significant proportion of opioid naïve non-surgical ICU survivors receive a new opioid prescription on hospital discharge. •A significant proportion of opioid naïve non-surgical ICU survivors receive a new opioid prescription on hospital discharge.•An estimate of the incidence of new prescription of enteral opioids in non-surgical, opioid naïve, ICU patients•Patient and ICU specific risk factors associated with such occurrence•Limiting the duration of opioids and reducing the use of antidepressants during the ICU stay may reduce this incidence.