TY - JOUR
T1 - Persistent post-discharge opioid prescribing after traumatic brain injury requiring intensive care unit admission
T2 - A cross-sectional study with longitudinal outcome
AU - Dunn, Lauren K.
AU - Taylor, Davis G.
AU - Smith, Samantha J.
AU - Skojec, Alexander J.
AU - Wang, Tony R.
AU - Chung, Joyce
AU - Hanak, Mark F.
AU - Lacomis, Christopher D.
AU - Palmer, Justin D.
AU - Ruminski, Caroline
AU - Fang, Shenghao
AU - Tsang, Siny
AU - Spangler, Sarah N.
AU - Durieux, Marcel E.
AU - Naik, Bhiken I.
N1 - Publisher Copyright:
© 2019 Dunn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Traumatic brain injury (TBI) is associated with increased risk for psychological and substance use disorders. The study aim is to determine incidence and risk factors for persistent opioid prescription after hospitalization for TBI. Electronic medical records of patients age ≥ 18 admitted to a neuroscience intensive care unit between January 2013 and February 2017 for an intracranial injury were retrospectively reviewed. Primary outcome was opioid use through 12 months post-hospital discharge. A total of 298 patients with complete data were included in the analysis. The prevalence of opioid use among preadmission opioid users was 48 (87%), 36 (69%) and 22 (56%) at 1, 6 and 12-months post-discharge, respectively. In the opioid naïve group, 69 (41%), 24 (23%) and 17 (19%) were prescribed opioids at 1, 6 and 12 months, respectively. Preadmission opioid use (OR 324.8, 95% CI 23.1–16907.5, p = 0.0004) and higher opioid requirements during hospitalization (OR 4.5, 95% CI 1.8–16.3, p = 0.006) were independently associated with an increased risk of being prescribed opioids 12 months post-discharge. These factors may be used to identify and target at-risk patients for intervention.
AB - Traumatic brain injury (TBI) is associated with increased risk for psychological and substance use disorders. The study aim is to determine incidence and risk factors for persistent opioid prescription after hospitalization for TBI. Electronic medical records of patients age ≥ 18 admitted to a neuroscience intensive care unit between January 2013 and February 2017 for an intracranial injury were retrospectively reviewed. Primary outcome was opioid use through 12 months post-hospital discharge. A total of 298 patients with complete data were included in the analysis. The prevalence of opioid use among preadmission opioid users was 48 (87%), 36 (69%) and 22 (56%) at 1, 6 and 12-months post-discharge, respectively. In the opioid naïve group, 69 (41%), 24 (23%) and 17 (19%) were prescribed opioids at 1, 6 and 12 months, respectively. Preadmission opioid use (OR 324.8, 95% CI 23.1–16907.5, p = 0.0004) and higher opioid requirements during hospitalization (OR 4.5, 95% CI 1.8–16.3, p = 0.006) were independently associated with an increased risk of being prescribed opioids 12 months post-discharge. These factors may be used to identify and target at-risk patients for intervention.
UR - http://www.scopus.com/inward/record.url?scp=85075608199&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0225787
DO - 10.1371/journal.pone.0225787
M3 - Article
C2 - 31774864
AN - SCOPUS:85075608199
SN - 1932-6203
VL - 14
JO - PloS one
JF - PloS one
IS - 11
M1 - e0225787
ER -