Report: ICU Opioid Admissions, Deaths on the Rise

Opioid death rate increased by 86% between 2009 and 2015, researchers find

In-hospital opioid overdose deaths among intensive care patients in the United States have increased by a rate of 0.5% each month since 2009, according to a study scheduled to be presented at ATS 2016, the international meeting of the American Thoracic Society. The findings were reported by MedPage Today.

After reviewing billing-code data involving 4.9 million intensive care unit (ICU) admissions at more than 200 hospitals in 44 states, researchers found a 46% increase in ICU admissions for opioid overdoses during the six-year period between 2009 and 2015, and an 86% increase in opioid deaths.

“What this means is that the opioid-use epidemic has probably reached a new level of crisis, and that despite everything we do in the ICU to keep patients alive, including ventilation, acute dialysis, life support, and around-the-clock care, we are not seeing an improvement in mortality,” said Jennifer P. Stevens, MD, of Beth Israel Deaconess Hospital in Boston, who will present the findings at the ATS meeting.

Stevens and her colleagues analyzed data from hospitals affiliated with Vizient (formerly known as the University Health System Consortium), and their final cohort included 17.6 million hospital adult admissions.

The data showed that both opioid overdose-related hospital admissions and ICU admissions increased, with ICU admissions for opioid overdoses rising from 45 patients per 10,000 ICU admissions in 2009 to 65 patients per 10,000 ICU admissions in 2015. The rate of acute dialysis in opioid-overdose patients also increased in ICUs.

According to Dean Schaufnagel, MD, of the University of Illinois at Chicago, who was not involved in the study, changing clinicians’ views about how they manage their patients’ pain is critical to addressing the current prescription-opioid overdose epidemic in the U.S.

“The thinking a decade or so ago was that doctors had no right to allow patients to be in pain,” he said. “When I had a wisdom tooth taken out a few years ago, they gave me a big bottle of Tylenol with codeine, and there was a refill. That was part of this mindset of making sure patients had no pain. This was well meaning, but that thinking backfired.”

Source: MedPage Today; May 17, 2016.