"Predictors of inpatient narcotic overdose in a non-surgical population"

"Predictors of inpatient narcotic overdose in a non-surgical population"

Bibliographic Details
Main Author: Aguilar, Carlos A., M.D.
Language:English
Published: University of Cincinnati / OhioLINK 2012
Subjects:
Surgery
Opioid
Narcotic
Overdose
Inpatient
Hospitalized
Naloxone
Online Access:http://rave.ohiolink.edu/etdc/view?acc_num=ucin1342728730
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spelling ndltd-OhioLink-oai-etd.ohiolink.edu-ucin13427287302021-08-03T06:15:48Z "Predictors of inpatient narcotic overdose in a non-surgical population" Aguilar, Carlos A., M.D. Surgery Opioid Narcotic Overdose Inpatient Hospitalized Naloxone Background: Medication errors are a common cause of injuries sustained in hospitals and up to 6% are related to opioids. A challenging task for clinicians is to find the perfect balance between providing effective analgesia and preventing adverse eventsObjective: Evaluate the incidence and risk factors associated with opioid overdose in a non-surgical inpatient population. Methods: A case-control study based on information from the electronic health record following discharge from a large community hospital in Cincinnati, OH between June and December 2008. Participants were adults hospitalized on medical wards and receiving opioid therapy. Cases met clinical criteria for opioid overdose and were treated with Naloxone, while. controls were randomly selected from the same time interval. We excluded patients admitted for opioid overdose, those on patient controlled analgesia, or those in a perioperative setting including same-day outpatient procedures.Main Measures: Opioid overdose events, patient demographics, laboratory values, comorbidities, type and number of opioids used, dose in morphine equivalents and other psychotropic medications used. Results: Of a total of 19,111 patient discharges, 40 (0.21%) met the case inclusion criteria for opioid overdose. Patients with overdoses had a lower weight and were receiving higher opioid doses both prior and during the hospitalization. Hydromorphone was the opioid most frequently associated with overdose events while Hydrocodone was the least. Multivariate logistic regression analyses showed older age (OR 1.06 [95% CI 1.01 to 1.11], p= 0.012), serum creatinine (OR 1.36 [95% CI 1.07 to 1.73], p=0.011) and 24-hour total morphine equivalents received (OR 1.01 [1.00 to 1.02], p=0.002) to be most highly associated with overdose. Hydrocodone use (OR 0.12 [95% CI 0.02 to 0.69], p=0.018) was associated with a decreased risk of overdose. Conclusions: Opioid overdose events were more frequent among older patients with increased creatinine levels, receiving a high morphine equivalent dose and who were less likely to be treated with Hydrocodone. We were unable to demonstrate that prior opioid therapy, other comorbidities and concomitant use of benzodiazepines were related to an increased rate of adverse outcomes. 2012-10-08 English text University of Cincinnati / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=ucin1342728730 http://rave.ohiolink.edu/etdc/view?acc_num=ucin1342728730 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.
collection NDLTD
language English
sources NDLTD
topic Surgery
Opioid
Narcotic
Overdose
Inpatient
Hospitalized
Naloxone
spellingShingle Surgery
Opioid
Narcotic
Overdose
Inpatient
Hospitalized
Naloxone
Aguilar, Carlos A., M.D.
"Predictors of inpatient narcotic overdose in a non-surgical population"
author Aguilar, Carlos A., M.D.
author_facet Aguilar, Carlos A., M.D.
author_sort Aguilar, Carlos A., M.D.
title "Predictors of inpatient narcotic overdose in a non-surgical population"
title_short "Predictors of inpatient narcotic overdose in a non-surgical population"
title_full "Predictors of inpatient narcotic overdose in a non-surgical population"
title_fullStr "Predictors of inpatient narcotic overdose in a non-surgical population"
title_full_unstemmed "Predictors of inpatient narcotic overdose in a non-surgical population"
title_sort "predictors of inpatient narcotic overdose in a non-surgical population"
publisher University of Cincinnati / OhioLINK
publishDate 2012
url http://rave.ohiolink.edu/etdc/view?acc_num=ucin1342728730
work_keys_str_mv AT aguilarcarlosamd predictorsofinpatientnarcoticoverdoseinanonsurgicalpopulation
_version_ 1719433664251559936

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