Respiratory failure & ventilation
Intravenous Opioid Administration During Mechanical Ventilation and Use After Hospital Discharge
Authors' conclusion
In this retrospective cohort study of patients receiving mechanical ventilation, opioids administered during mechanical ventilation were associated with opioid prescriptions following hospital discharge.
Study context
- Population
- Medical (nonsurgical) adults with mechanical ventilation ≥24 hours for acute respiratory failure surviving hospitalization, 21 Kaiser Permanente Northern California hospitals, 2012–2019
- Participants
- 6,746 participants · 21 hospitals
- Exposure
- Terciles of median daily IV fentanyl equivalents during mechanical ventilation vs no opioids
- No opioidsn = 1,013reference
- Outcome
- First filled opioid prescription after discharge
- Follow-up
- 1 year
Methodological detailsmulticentre, multivariable-adjusted time-to-event analyses, death as competing risk
- Multicentre
- Multivariable-adjusted time-to-event analyses
- Death as competing risk
Main finding
As reported in the abstract
Each group vs no opioidsAdjusted hazard ratio (95% CI)
Tercile 1
1.00(0.85–1.17)
Tercile 2
1.20(1.03–1.40)
Tercile 3
1.25(1.07–1.47)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | |
|---|---|---|
| Persistent opioid use after hospitalizationTercile 3 vs No opioids | 1.44 (1.14–1.83) | |
| 0.512Odds ratio (log scale) |
- Persistent opioid use after hospitalization: n = 1410 outcomes
Interaction between opioid dose during mechanical ventilation, prior opioid use and posthospitalization opioid use
- No interaction observed
Original publication
Intravenous Opioid Administration During Mechanical Ventilation and Use After Hospital Discharge. JAMA Netw Open. Published 3 June 2024. doi:10.
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