New persistent opioid use among intensive care unit (ICU) survivors after discharge: incidence, predictors, and nationwide cohort analysis
Authors' conclusion
Approximately one in 25 ICU survivors developed new persistent opioid use by six months. Early post-discharge opioid prescription was the dominant risk factor. Risk profiles differed by opioid potency
Study context
- Population
- Opioid-naïve adult ICU survivors alive ≥6 months after discharge, South Korea National Health Insurance Service database, 2020–2022
- Participants
- 567,260 opioid-naïve ICU survivors
- Outcome
- New persistent opioid use (≥1 outpatient opioid prescription within 90 days after discharge and ≥1 additional prescription between 91 and 180 days)
- Follow-up
- 6 months
Methodological detailsnationwide, multivariable logistic regression
- Nationwide
- Multivariable logistic regression
Main finding
As reported in the abstract
New persistent opioid use · six months
Opioid-naïve ICU survivors
4.2%
23,945 events
Observational data: associations, not effects.
Further findings
Opioid type received
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Independent predictors of new persistent opioid useOlder age (per year) · multivariable logistic regression | 1.01 (1.01–1.02) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Independent predictors of new persistent opioid use
| OR (95% CI) | P value | ||
|---|---|---|---|
| Female sexMultivariable logistic regression | 1.13 (1.09–1.16) | P < 0.001 | |
| Socioeconomic disadvantage (Medical Aid)Multivariable logistic regression | 1.30 (1.23–1.38) | P < 0.001 | |
| MalignancyMultivariable logistic regression | 1.05 (1.01–1.09) | P = 0.017 | |
| Metastatic tumorMultivariable logistic regression | 1.24 (1.15–1.35) | P < 0.001 | |
| ECMOMultivariable logistic regression | 1.80 (1.75–1.89) | P < 0.001 | |
| CRRTMultivariable logistic regression | 1.24 (1.11–1.37) | P < 0.001 | |
| Early opioid prescription within 30 days of dischargeStrongest predictor · multivariable logistic regression | 19.7 (19.1–20.3) | P < 0.001 | |
| 0.050.21520Odds ratio (log scale) |
Potency-specific predictors
- Potent opioid persistence largely driven by cancer; less-potent use shaped more by demographic and socioeconomic factors
Original publication
New persistent opioid use among ICU survivors after discharge: incidence, predictors, and nationwide cohort analysis. Crit Care. Published 3 November 2025. doi:10.
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