Open AccessPersistent post-discharge opioid prescribing after traumatic brain injury requiring intensive care unit admission: A cross-sectional study with longitudinal outcome
Author(s) -
Lauren K. Dunn,
Davis G. Taylor,
Samantha J. Smith,
Alexander J. Skojec,
Tony R. Wang,
Joyce Chung,
Mark F. Hanak,
Christopher D. Lacomis,
Justin D. Palmer,
Caroline Ruminski,
Shenghao Fang,
Siny Tsang,
Sarah N. Spangler,
Marcel E. Durieux,
Bhiken I. Naik
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0225787
Subject(s) - cross sectional study , medicine , traumatic brain injury , intensive care unit , emergency medicine , opioid , patient discharge , young adult , anesthesia , medline , intensive care medicine , psychiatry , receptor , political science , law , pathology
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.