Older Age, ICU, Poor Renal Function Up Opioid Overdose

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For hospitalized patients, risk also increased for those receiving 3 or more CNS antidepressants.
For hospitalized patients, risk also increased for those receiving 3 or more CNS antidepressants.

(HealthDay News) -- 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 in the Journal of Clinical Pharmacy and Therapeutics.

Quyen Vu, PharmD, 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 vs 29.5%; P=0.026), being in an ICU (medical ICU/cardiac ICU: 27.3 vs 3.4%; P<0.001; surgical ICU: 18.1 vs 5.7%; P=0.031), and having renal impairment (estimated glomerular filtration rate ≤60: 50 vs 28.4%; 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 vs 107.2 mg morphine equivalent; P=0.116). Overdose cases were more likely to have received concomitant central nervous system antidepressants; only those receiving 3 or more had a statistically significant difference (15.9 vs 0%; P<0.001). The only comorbidity significantly associated with increased risk of opioid overdose was heart disease (43.2 vs 20.5%; P=0.025).

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

Reference

Vu Q, Beselman A, Monolakis J, Wang A, and Rastegar D. Risk factors for opioid overdose among hospitalized patients. DOI: 10.1111/jcpt.12701. J Clin Pharm Ther. [Published online May 23, 2018]

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