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Older Age, ICU, Poor Renal Fcn Up Risk of Opioid OD in Hospital

TUESDAY, June 12, 2018 -- Risk factors for opioid overdose among hospitalized patients include being age 65 years or older, being in an intensive care unit (ICU), and having renal impairment, according to a study published online May 23 in the Journal of Clinical Pharmacy and Therapeutics.

Quyen Vu, Pharm.D., from the University of Maryland School of Pharmacy in Baltimore, and colleagues examined risk factors for opioid overdose. Data were included for 44 cases of opioid overdose and 88 controls (no overdose) from a single institution.

The researchers found that being age 65 years or older (40.9 versus 29.5 percent; P = 0.026), being in an ICU (medical ICU/cardiac ICU: 27.3 versus 3.4 percent; P < 0.001; surgical ICU: 18.1 versus 5.7 percent; P = 0.031), and having renal impairment (estimated glomerular filtration rate ≤60: 50 versus 28.4 percent; P = 0.034) were associated with opioid overdose. The overdose group had lower total 24-hour opioid dose, but the difference was not statistically significant (71.9 versus 107.2 mg morphine equivalent; P = 0.116). Overdose cases were more likely to have received concomitant central nervous system antidepressants; only those receiving three or more had a statistically significant difference (15.9 versus 0 percent; P < 0.001). The only comorbidity significantly associated with increased risk of opioid overdose was heart disease (43.2 versus 20.5 percent; P = 0.025).

"These findings may help with the development and implementation of measures to prevent overdose," the authors write.

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Posted: June 2018


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