• Han Ting Wang, Andrea D Hill, Tara Gomes, Ruxandra Pinto, Duminda N Wijeysundera, Damon C Scales, Robert A Fowler, and Hannah Wunsch.
• Critical Care Division, Department of Medicine, Maisonneuve-Rosemont Hospital affiliated with the University of Montreal, Montreal, QC, Canada.
• J Crit Care. 2020 Feb 1; 55: 128-133.

PurposeTo assess temporal trends in pre-existing opioid exposure prior to hospitalization among elderly intensive care unit (ICU) patients and its association with adverse outcomes.Materials And MethodsWe performed a population-based retrospective cohort study using health administrative data from the province of Ontario, Canada. We included all older adult (> 65 years) admissions to an ICU between April 2002 and March 2015. The exposure was opioid use before admission categorized as chronic use, intermittent use, and non-use.ResultsThe cohort included 711,312 elderly patient admissions to an ICU. Of these, 6.8% (n = 48,363) were chronic opioid users, 28.1% (n = 200,149) intermittent users, and 65.0% (n = 462,800) non-users. Compared with non-users, chronic opioid users and intermittent users had higher in-hospital mortality (adjusted odds ratio: 1.12, 95% CI, 1.09-1.15, p < 0.0001 for chronic users; adjusted odds ratio: 1.09, 95% CI, 1.07-1.11, p < 0.0001 for intermittent users), and a lower subdistribution hazard of time to hospital discharge, translating to a longer hospital length of stay (adjusted hazard ratio: 0.87, 95% CI, 0.85-0.88, p < 0.0001 for chronic users; adjusted hazard ratio: 0.93, 95% CI, 0.92-0.94, p < 0.0001 for intermittent users).ConclusionsAmong elderly ICU patients, opioid exposure prior to admission is prevalent and use is associated with higher in-hospital mortality.Copyright © 2019 Elsevier Inc. All rights reserved.

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