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Short‐term mortality following tramadol poisonings in Denmark
Author(s) -
Sørensen Anne Mette Skov,
Petersen Janne,
Christensen Mikkel Bring,
Schelde Astrid Blicher,
Andersen Jon Trærup,
Jimenez Solem Espen,
Petersen Tonny Studsgaard
Publication year - 2022
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/bcpt.13741
Subject(s) - tramadol , oxycodone , medicine , morphine , opioid , hazard ratio , proportional hazards model , poison control , anesthesia , confidence interval , emergency medicine , analgesic , receptor
Tramadol is a commonly used opioid with a potential of addiction and abuse. Using Danish nationwide registers, we aimed to (1) characterise opioid poisonings; (2) assess the 30‐day mortality following morphine, oxycodone, and mixed poisonings compared to tramadol poisonings; and (3) assess the development in tramadol poisonings during a 12‐year period. Poisonings were identified from 2006 to 2017. A Cox proportional hazards regression model was used to estimate adjusted hazard ratios (aHRs) along with 95% confidence intervals (CIs) for 30‐day mortality following morphine, oxycodone or mixed poisonings compared to tramadol poisonings. We identified 7718 opioid poisonings among 6365 patients. The patients with a tramadol poisoning were younger and had less comorbidities than the patients with a morphine, oxycodone or mixed poisoning. Within 30 days, a total of 205 patients died. The 30‐day mortality risk was higher following morphine (aHR 3.2, 95% CI 2.0–5.1), oxycodone (aHR 2.1, 95% CI 1.2–3.6) and mixed poisonings (aHR 1.6, 95% CI 1.0–2.7) compared to tramadol poisonings. The annual number of tramadol poisonings increased from 233 in 2006 to 501 in 2013 and declined to 348 in 2017. In conclusion, despite a lower mortality risk compared to other opioid poisonings, physicians should consider the poisoning and abuse risks when prescribing tramadol.

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