Opioid Poisoning and Opioid Use Disorder in Older Trauma Patients

被引：5

作者：

Daoust, Raoul ^{[1
,2
]}

Paquet, Jean ^{[1
]}

Moore, Lynne ^{[3
,4
]}

Cournoyer, Alexis ^{[1
,2
]}

Ennond, Marcel ^{[5
]}

Gosselin, Sophie ^{[6
,7
]}

Lavigne, Gilles J. ^{[8
,9
]}

Boulanger, Aline ^{[10
,11
]}

Mac-Thiong, Jean-Marc ^{[2
,12
]}

Chauny, Jean-Marc ^{[1
,2
]}

机构：

[1] Hop Sacre Coeur Montreal, Ctr Etud Med Urgence, Montreal, PQ, Canada

[2] Univ Montreal, Fac Med, Dept Med Familiale & Med Urgence, Montreal, PQ, Canada

[3] Univ Laval, Fac Med, Dept Med Sociale & Prevent, Quebec City, PQ, Canada

[4] CHU Quebec, Axe Rech Traumatol Urgence Soins Intensifs Ctr Re, Quebec City, PQ, Canada

[5] Univ Laval, Fac Med, Dept Med Familiale & Med Urgence, Quebec City, PQ, Canada

[6] McGill Univ, Hlth Ctr, Dept Emergency Med, Montreal, PQ, Canada

[7] CISSS Monteregie Ctr, Dept Med Urgence, Greenfield Pk, PQ, Canada

[8] Univ Montreal, Fac Dent Med & Med, Montreal, PQ, Canada

[9] Hop Sacre Coeur Montreal CIUSSS Nord Ile de Montr, Ctr Adv Res Sleep Med, Montreal, PQ, Canada

[10] Ctr Rech Ctr Hosp Univ Montreal CRCHUM, Montreal, PQ, Canada

[11] Univ Montreal, Fac Med, Dept Anesthesiol, Montreal, PQ, Canada

[12] Hop Sacre Coeur CIUSSS Nord Ile de Montreal, Res Ctr, Montreal, PQ, Canada

来源：

CLINICAL INTERVENTIONS IN AGING | 2020年 / 15卷

关键词：

prescription opioids; opioid poisoning; opioid use disorder; trauma; injury; older adults; RISK-FACTORS; CHRONIC PAIN; OVERDOSE; MISUSE; TRENDS; ABUSE;

D O I：

10.2147/CIA.S252849

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Background: Patients hospitalized following a traumatic injury will be frequently treated with opioids during their stay and after discharge. We examined the relationship between acute phase (<3 months) opioid use after discharge and the risk of opioid poisoning or use disorder in older trauma patients. Methods: In a retrospective multicenter cohort study conducted on registry data, we included all patients >= 65 years admitted (hospital stay >2 days) for injury in 57 trauma centers in the province of Quebec (Canada) between 2004 and 2014. We searched for opioid poisoning and opioid use disorder from ICD-9 to ICD-10 code diagnosis after their initial injury. Patients that filled an opioid prescription within a 3-month period after sustaining the trauma were compared to those who did not, using Cox proportional hazards regressions. Results: A total of 70,314 admissions were retained for analysis; median age was 82 years (IQR: 75-87), 68% were women, and 34% of the patients filled an opioid prescription within 3 months of the initial trauma. During a median follow-up of 2.6 years (IQR: 1-5), 192 participants (0.27%; 95% CI: 0.23%-0.31%) were hospitalized for opioid poisoning and 73 (0.10%; 95% CI: 0.08%-0.13%) were diagnosed with opioid use disorder. Having filled an opioid prescription within 3 months of injury was associated with an increased hazard ratio of opioid poisoning (2.8; 95% CI: 2.1-3.8) and opioid use disorder (4.2; 95% CI: 2.4-7.4) after the injury. However, history of opioid poisoning (2.6; 95% CI: 1.1-5.8), of substance use disorder (4.3; 95% CI: 2.4-7.7), or of the opioid prescription filled (2.8; 95% CI: 2.2-3.6) before the trauma, was also related to opioid poisoning or opioid use disorder after the injury. Conclusion: Opioid poisoning and opioid use disorder are rare events after hospitalization for trauma in older patients. However, opioids should be used cautiously in patients with a history of substance use disorder, opioid poisoning or opioid use.

引用

页码：763 / 770

页数：8

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