Short- and long-term opioid use in survivors of subarachnoid hemorrhage.
Journal Article (Journal Article)
OBJECTIVES: Opioids are frequently used for analgesia in patients with acute subarachnoid hemorrhage (SAH) due to a high prevalence of headache and neck pain. However, it is unclear if this practice may pose a risk for opioid dependence, as long-term opioid use in this population remains unknown. We sought to determine the prevalence of opioid use in SAH survivors, and to identify potential risk factors for opioid utilization. METHODS: We analyzed a cohort of consecutive patients admitted with non-traumatic and suspected aneurysmal SAH to an academic referral center. We included patients who survived hospitalization and excluded those who were not opioid-naïve. Potential risk factors for opioid prescription at discharge, 3 and 12 months post-discharge were assessed. RESULTS: Of 240 SAH patients who met our inclusion criteria (mean age 58.4 years [SD 14.8], 58% women), 233 (97%) received opioids during hospitalization and 152 (63%) received opioid prescription at discharge. Twenty-eight patients (12%) still continued to use opioids at 3 months post-discharge, and 13 patients (6%) at 12-month follow up. Although patients with poor Hunt and Hess grades (odds ratio 0.19, 95% CI 0.06-0.57) and those with intraventricular hemorrhage (odds ratio 0.38, 95% CI 0.18-0.87) were less likely to receive opioid prescriptions at discharge, we did not find significant differences between patients who had long-term opioid use and those who did not. CONCLUSION: Opioids are regularly used in both the acute SAH setting and immediately after discharge. A considerable number of patients also continue to use opioids in the long-term. Opioid-sparing pain control strategies should be explored in the future.
Full Text
Duke Authors
Cited Authors
- Mahta, A; Anderson, MN; Azher, AI; Mahmoud, LN; Dakay, K; Abdulrazeq, H; Abud, A; Moody, S; Reznik, ME; Yaghi, S; Thompson, BB; Wendell, LC; Rao, SS; Potter, NS; Cutting, S; Mac Grory, B; Stretz, C; Doberstein, CE; Furie, KL
Published Date
- August 2021
Published In
Volume / Issue
- 207 /
Start / End Page
- 106770 -
PubMed ID
- 34182238
Electronic International Standard Serial Number (EISSN)
- 1872-6968
Digital Object Identifier (DOI)
- 10.1016/j.clineuro.2021.106770
Language
- eng
Conference Location
- Netherlands