Opioid Poisoning and Opioid Use Disorder in Older Trauma Patients

Raoul Daoust,1,2 Jean Paquet,1 Lynne Moore,3,4 Alexis Cournoyer,1,2 Marcel Émond,5 Sophie Gosselin,6,7 Gilles J Lavigne,8,9 Aline Boulanger,10,11 Jean-Marc Mac-Thiong,2,12 Jean-Marc Chauny1,2 1Centre d’Étude en Médecine d’Urgence, Hôpita...

Description complète

Enregistré dans:

Détails bibliographiques
Auteurs principaux:	Daoust R, Paquet J, Moore L, Cournoyer A, Émond M, Gosselin S, Lavigne GJ, Boulanger A, Mac-Thiong JM, Chauny JM
Format:	article
Langue:	EN
Publié:	Dove Medical Press 2020
Sujets:	prescription opioids opioid poisoning opioid use disorder trauma older adults Geriatrics RC952-954.6
Accès en ligne:	https://doaj.org/article/4ef319f848004a689999f74802a76891
Tags:	Ajouter un tag Pas de tags, Soyez le premier à ajouter un tag!

id	oai:doaj.org-article:4ef319f848004a689999f74802a76891
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	prescription opioids opioid poisoning opioid use disorder trauma older adults Geriatrics RC952-954.6
spellingShingle	prescription opioids opioid poisoning opioid use disorder trauma older adults Geriatrics RC952-954.6 Daoust R Paquet J Moore L Cournoyer A Émond M Gosselin S Lavigne GJ Boulanger A Mac-Thiong JM Chauny JM Opioid Poisoning and Opioid Use Disorder in Older Trauma Patients
description	Raoul Daoust,1,2 Jean Paquet,1 Lynne Moore,3,4 Alexis Cournoyer,1,2 Marcel Émond,5 Sophie Gosselin,6,7 Gilles J Lavigne,8,9 Aline Boulanger,10,11 Jean-Marc Mac-Thiong,2,12 Jean-Marc Chauny1,2 1Centre d’Étude en Médecine d’Urgence, Hôpital du Sacré-Coeur de Montréal, Montréal, Quebec, Canada; 2Département Médecine Familiale et Médecine d’Urgence, Faculté de Médecine, Université de Montréal, Montréal, Quebec, Canada; 3Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, Quebec, Canada; 4Axe de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQS du CHU-Québec, Quebec, Quebec, Canada; 5Département de médecine familiale et de médecine d’urgence, Faculté DE médecine, Université Laval, Quebec, Quebec, Canada; 6Department of Emergency Medicine, McGill University Health Centre, McGill University, Montréal, Quebec, Canada; 7Département de médecine d’urgence, CISSS-Montérégie-Centre, Greenfield Park, Québec, Canada; 8Faculties of Dental Medicine and Medicine, Université de Montréal, Montréal, Quebec, Canada; 9Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l’Île-de-Montréal), Montréal, Quebec, Canada; 10Centre de recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, Quebec, Canada; 11Département d’anesthésiologie, Faculté de médecine, Université de Montréal, Montréal, Quebec, Canada; 12Research Centre, Hôpital du Sacré-Coeur (CIUSSS du Nord de-l’île-de-Montréal), Montréal, Quebec, CanadaCorrespondence: Raoul Daoust Email raoul.daoust@videotron.caBackground: Patients hospitalized following a traumatic injury will be frequently treated with opioids during their stay and after discharge. We examined the relationship between acute phase (< 3 months) opioid use after discharge and the risk of opioid poisoning or use disorder in older trauma patients.Methods: In a retrospective multicenter cohort study conducted on registry data, we included all patients ≥ 65 years admitted (hospital stay > 2 days) for injury in 57 trauma centers in the province of Quebec (Canada) between 2004 and 2014. We searched for opioid poisoning and opioid use disorder from ICD-9 to ICD-10 code diagnosis after their initial injury. Patients that filled an opioid prescription within a 3-month period after sustaining the trauma were compared to those who did not, using Cox proportional hazards regressions.Results: A total of 70,314 admissions were retained for analysis; median age was 82 years (IQR: 75– 87), 68% were women, and 34% of the patients filled an opioid prescription within 3 months of the initial trauma. During a median follow-up of 2.6 years (IQR: 1– 5), 192 participants (0.27%; 95% CI: 0.23%-0.31%) were hospitalized for opioid poisoning and 73 (0.10%; 95% CI: 0.08%-0.13%) were diagnosed with opioid use disorder. Having filled an opioid prescription within 3 months of injury was associated with an increased hazard ratio of opioid poisoning (2.8; 95% CI: 2.1– 3.8) and opioid use disorder (4.2; 95% CI: 2.4– 7.4) after the injury. However, history of opioid poisoning (2.6; 95% CI: 1.1– 5.8), of substance use disorder (4.3; 95% CI: 2.4– 7.7), or of the opioid prescription filled (2.8; 95% CI: 2.2– 3.6) before the trauma, was also related to opioid poisoning or opioid use disorder after the injury.Conclusion: Opioid poisoning and opioid use disorder are rare events after hospitalization for trauma in older patients. However, opioids should be used cautiously in patients with a history of substance use disorder, opioid poisoning or opioid use.Keywords: prescription opioids, opioid poisoning, opioid use disorder, trauma, injury, older adults
format	article
author	Daoust R Paquet J Moore L Cournoyer A Émond M Gosselin S Lavigne GJ Boulanger A Mac-Thiong JM Chauny JM
author_facet	Daoust R Paquet J Moore L Cournoyer A Émond M Gosselin S Lavigne GJ Boulanger A Mac-Thiong JM Chauny JM
author_sort	Daoust R
title	Opioid Poisoning and Opioid Use Disorder in Older Trauma Patients
title_short	Opioid Poisoning and Opioid Use Disorder in Older Trauma Patients
title_full	Opioid Poisoning and Opioid Use Disorder in Older Trauma Patients
title_fullStr	Opioid Poisoning and Opioid Use Disorder in Older Trauma Patients
title_full_unstemmed	Opioid Poisoning and Opioid Use Disorder in Older Trauma Patients
title_sort	opioid poisoning and opioid use disorder in older trauma patients
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/4ef319f848004a689999f74802a76891
work_keys_str_mv	AT daoustr opioidpoisoningandopioidusedisorderinoldertraumapatients AT paquetj opioidpoisoningandopioidusedisorderinoldertraumapatients AT moorel opioidpoisoningandopioidusedisorderinoldertraumapatients AT cournoyera opioidpoisoningandopioidusedisorderinoldertraumapatients AT emondm opioidpoisoningandopioidusedisorderinoldertraumapatients AT gosselins opioidpoisoningandopioidusedisorderinoldertraumapatients AT lavignegj opioidpoisoningandopioidusedisorderinoldertraumapatients AT boulangera opioidpoisoningandopioidusedisorderinoldertraumapatients AT macthiongjm opioidpoisoningandopioidusedisorderinoldertraumapatients AT chaunyjm opioidpoisoningandopioidusedisorderinoldertraumapatients
_version_	1718397459755958272
spelling	oai:doaj.org-article:4ef319f848004a689999f74802a768912021-12-02T10:15:16ZOpioid Poisoning and Opioid Use Disorder in Older Trauma Patients1178-1998https://doaj.org/article/4ef319f848004a689999f74802a768912020-05-01T00:00:00Zhttps://www.dovepress.com/opioid-poisoning-and-opioid-use-disorder-in-older-trauma-patients-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Raoul Daoust,1,2 Jean Paquet,1 Lynne Moore,3,4 Alexis Cournoyer,1,2 Marcel Émond,5 Sophie Gosselin,6,7 Gilles J Lavigne,8,9 Aline Boulanger,10,11 Jean-Marc Mac-Thiong,2,12 Jean-Marc Chauny1,2 1Centre d’Étude en Médecine d’Urgence, Hôpital du Sacré-Coeur de Montréal, Montréal, Quebec, Canada; 2Département Médecine Familiale et Médecine d’Urgence, Faculté de Médecine, Université de Montréal, Montréal, Quebec, Canada; 3Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, Quebec, Canada; 4Axe de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQS du CHU-Québec, Quebec, Quebec, Canada; 5Département de médecine familiale et de médecine d’urgence, Faculté DE médecine, Université Laval, Quebec, Quebec, Canada; 6Department of Emergency Medicine, McGill University Health Centre, McGill University, Montréal, Quebec, Canada; 7Département de médecine d’urgence, CISSS-Montérégie-Centre, Greenfield Park, Québec, Canada; 8Faculties of Dental Medicine and Medicine, Université de Montréal, Montréal, Quebec, Canada; 9Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l’Île-de-Montréal), Montréal, Quebec, Canada; 10Centre de recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, Quebec, Canada; 11Département d’anesthésiologie, Faculté de médecine, Université de Montréal, Montréal, Quebec, Canada; 12Research Centre, Hôpital du Sacré-Coeur (CIUSSS du Nord de-l’île-de-Montréal), Montréal, Quebec, CanadaCorrespondence: Raoul Daoust Email raoul.daoust@videotron.caBackground: Patients hospitalized following a traumatic injury will be frequently treated with opioids during their stay and after discharge. We examined the relationship between acute phase (< 3 months) opioid use after discharge and the risk of opioid poisoning or use disorder in older trauma patients.Methods: In a retrospective multicenter cohort study conducted on registry data, we included all patients ≥ 65 years admitted (hospital stay > 2 days) for injury in 57 trauma centers in the province of Quebec (Canada) between 2004 and 2014. We searched for opioid poisoning and opioid use disorder from ICD-9 to ICD-10 code diagnosis after their initial injury. Patients that filled an opioid prescription within a 3-month period after sustaining the trauma were compared to those who did not, using Cox proportional hazards regressions.Results: A total of 70,314 admissions were retained for analysis; median age was 82 years (IQR: 75– 87), 68% were women, and 34% of the patients filled an opioid prescription within 3 months of the initial trauma. During a median follow-up of 2.6 years (IQR: 1– 5), 192 participants (0.27%; 95% CI: 0.23%-0.31%) were hospitalized for opioid poisoning and 73 (0.10%; 95% CI: 0.08%-0.13%) were diagnosed with opioid use disorder. Having filled an opioid prescription within 3 months of injury was associated with an increased hazard ratio of opioid poisoning (2.8; 95% CI: 2.1– 3.8) and opioid use disorder (4.2; 95% CI: 2.4– 7.4) after the injury. However, history of opioid poisoning (2.6; 95% CI: 1.1– 5.8), of substance use disorder (4.3; 95% CI: 2.4– 7.7), or of the opioid prescription filled (2.8; 95% CI: 2.2– 3.6) before the trauma, was also related to opioid poisoning or opioid use disorder after the injury.Conclusion: Opioid poisoning and opioid use disorder are rare events after hospitalization for trauma in older patients. However, opioids should be used cautiously in patients with a history of substance use disorder, opioid poisoning or opioid use.Keywords: prescription opioids, opioid poisoning, opioid use disorder, trauma, injury, older adultsDaoust RPaquet JMoore LCournoyer AÉmond MGosselin SLavigne GJBoulanger AMac-Thiong JMChauny JMDove Medical Pressarticleprescription opioidsopioid poisoningopioid use disordertraumaolder adultsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 763-770 (2020)

Opioid Poisoning and Opioid Use Disorder in Older Trauma Patients

Documents similaires