Luis E Tollinche1, Kenneth P Seier2, Gloria Yang3, Kay See Tan4, Yekaterina D Tayban5, Stephen M Pastores6, Cindy B Yeoh7, Kunal Karamchandani8. 1. Department of Anesthesiology, MetroHealth Medical Center, USA. Electronic address: ltollinche@metrohealth.org. 2. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, USA. Electronic address: seierk@mskcc.org. 3. Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, USA. Electronic address: Yangg2@mskcc.org. 4. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, USA. Electronic address: tank@mskcc.org. 5. Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, USA. Electronic address: taybany@mskcc.org. 6. Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, USA. Electronic address: pastores@mskcc.org. 7. Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, USA. Electronic address: yeohc@mskcc.org. 8. Department of Anesthesiology and Pain Medicine, UT Southwestern Medical Center, USA. Electronic address: Kunal.Karamchandani@UTSouthwestern.edu.
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.
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.
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