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Abstract Details

Opioid use during hospitalization for Subarachnoid Hemorrhage is associated with continued use at follow up
Neuro Trauma, Critical Care, and Sports Neurology
P15 - Poster Session 15 (12:00 PM-1:00 PM)
13-015
To assess prevalence of and risk factors for prolonged opioid use following subarachnoid hemorrhage (SAH).
Prior work suggests that inpatient opioid prescribing may be associated with opioid dependence and contributes to the ongoing opioid epidemic.  Opioids are commonly prescribed during inpatient admissions for SAH, but the prevalence of continued opioid use following admission and the risk factors thereof are uncertain.
We performed a retrospective chart review of patients treated for SAH in the neurocritical care unit of a tertiary care center from January 2018 - February 2019. Continued opioid use was defined as presence on medication reconciliation (MAR) completed at follow-up. For patients seen multiple times, the last visit with inclusion of an opioid on MAR was reported.
Data was collected from 155 consecutive patients with SAH (median age 56, 74% female, HH grade 3). Seventy-four patients had continued opioid use at follow up. Median time to follow up was 43 days (IQR 29 – 76). Younger age (52.5 vs 59, p = 0.001), pre-hospital non-opioid analgesia (OR = 2.07, 95% CI 1.00 – 4.30 p = 0.05) and depression (OR = 3.86, 95% CI 1.33 – 11.24 p = 0.013) were associated with continued opioid use.  Patients who received opioids on the day of hospital discharge were twice as likely to have opioids on MAR at follow up compared to those who did not (RR = 2.33, 95% CI 1.61 – 3.36 p <0.0001) with a number needed to harm (NNH) of 2.5. Additionally, those who were discharged with a prescription for opioids were 8 times more likely to have continued opioid use (RR = 8.15, 95% CI 4.38 – 15.15 p <0.0001) with NNH of 1.26.
Inpatient opioid prescribing patterns following SAH may influence future opioid use. Further study is required to replicate our study’s findings in separate cohorts.
Authors/Disclosures
Matthew N. Jaffa, DO (Ayer Neuroscience Institute, Hartford Hospital)
PRESENTER 		Dr. Jaffa has nothing to disclose.
No disclosure on file
No disclosure on file
Melissa Motta, MD, MPH, FÂ鶹´«Ã½Ó³»­ (University Of Maryland Hospital in Baltimore) Dr. Motta has nothing to disclose.
Gunjan Parikh, MD (University of Maryland School of Medicine) The institution of Dr. Parikh has received research support from Department of Defense. The institution of Dr. Parikh has received research support from NINDS. The institution of Dr. Parikh has received research support from NIH.
Neeraj Badjatia, MD (University of Maryland School of Medicine) The institution of Dr. Badjatia has received research support from NIH/DOD.
Nicholas A. Morris, MD, FÂ鶹´«Ã½Ó³»­ (University of Maryland Medical Center) The institution of Dr. Morris has received research support from National Institute of Neurological Disorders and Stroke. The institution of Dr. Morris has received research support from Â鶹´«Ã½Ó³»­. The institution of Dr. Morris has received research support from National Institute of Neurological Disorders and Stroke. Dr. Morris has received personal compensation in the range of $500-$4,999 for serving as a Webinar Speaker with Kreg Therapeutics. Dr. Morris has a non-compensated relationship as a Editorial Board Member with Â鶹´«Ã½Ó³»­ that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Morris has a non-compensated relationship as a Editorial Board Member with Neurocritical Care Society that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.