Persistent post-discharge opioid prescribing after traumatic brain injury requiring intensive care unit admission: A cross-sectional study with longitudinal outcome


Autoři: Lauren K. Dunn aff001;  Davis G. Taylor aff002;  Samantha J Smith aff001;  Alexander J. Skojec aff001;  Tony R. Wang aff002;  Joyce Chung aff001;  Mark F. Hanak aff001;  Christopher D. Lacomis aff001;  Justin D. Palmer aff001;  Caroline Ruminski aff001;  Shenghao Fang aff001;  Siny Tsang aff003;  Sarah N. Spangler aff001;  Marcel E. Durieux aff001;  Bhiken I. Naik aff001
Působiště autorů: Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia, United States of America aff001;  Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States of America aff002;  Nutrition and Exercise Physiology, Washington State University, Spokane, Washington, United States of America aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225787

Souhrn

Traumatic brain injury (TBI) is associated with increased risk for psychological and substance use disorders. The study aim is to determine incidence and risk factors for persistent opioid prescription after hospitalization for TBI. Electronic medical records of patients age ≥ 18 admitted to a neuroscience intensive care unit between January 2013 and February 2017 for an intracranial injury were retrospectively reviewed. Primary outcome was opioid use through 12 months post-hospital discharge. A total of 298 patients with complete data were included in the analysis. The prevalence of opioid use among preadmission opioid users was 48 (87%), 36 (69%) and 22 (56%) at 1, 6 and 12-months post-discharge, respectively. In the opioid naïve group, 69 (41%), 24 (23%) and 17 (19%) were prescribed opioids at 1, 6 and 12 months, respectively. Preadmission opioid use (OR 324.8, 95% CI 23.1–16907.5, p = 0.0004) and higher opioid requirements during hospitalization (OR 4.5, 95% CI 1.8–16.3, p = 0.006) were independently associated with an increased risk of being prescribed opioids 12 months post-discharge. These factors may be used to identify and target at-risk patients for intervention.

Klíčová slova:

Antidepressants – Antipsychotics – Hospitals – Intensive care units – NSAIDs – Opioids – Surgical and invasive medical procedures – Traumatic brain injury


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Článek vyšel v časopise

PLOS One


2019 Číslo 11