(210) The Association of Opioid Use with Risk of ICU Admission and Mortality in The Adult Dutch Population

Saturday, August 27, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 884

Presenting Author(s)

Ajda Bedene, MPharm
– Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands

Co-Author(s)

Willem M. Lijfering, MD PhD
– Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
M. Sesmu Arbous
– Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
Frits R. Rosendaal, MD PhD
– Head of the Department, Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
Albert Dahan, MD PhD
– Department of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands
Eveline L.A. van Dorp, MD PhD
– Department of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands

Background: Opioid overdoses are on the rise in the Netherlands, and the burden of opioid use may extend beyond poisoning.

Objectives: Here, we investigate a relationship between opioid prescription status and one-year risk of unplanned intensive care unit (ICU) admission and death.

Methods: For this cohort study, comprised of several registries concerning the Dutch population, on 1 January 2018 alive adults were eligible and followed until either ICU admission, death, or 31 December 2018 occurred. Then, crude event rates and event specific hazard rates with 95% confidence interval (CI) in those with and without an opioid prescription–in the full cohort and in subgroups–were calculated.

Results: Rates of ICU admission and death in those with an opioid prescription were 5.87 and 62.2 per 1,000 person-years (PY) and rates of ICU admission and death in those without one were 2.03 and 6.34, respectively. Exposed residents had a 2.53-fold (95% CI 2.45-2.60) increased risk of ICU admission and a 7.11-fold (95% CI 7.02-7.19) increased mortality risk than unexposed residents. The risk of both outcomes was increased in users than in non-users regardless of the subgroup (adjusted hazard ratios greater than one) and it was influenced by the duration of opioid treatment; it was highest in chronic users (119 per 1,000 PY for death and 10.6 for ICU admission).

Conclusions: The risk of ICU admission and death was higher in opioid users than in non-opioid users, however, other explanatory variables, not accounted for, may be present. Nevertheless, dangers of opioid use may be far-reaching.