Long term opioid use following a burn injury

Jamal, S., Shaw, M., Quasim, T. , Puxty, K. and McGovern, C. (2024) Long term opioid use following a burn injury. British Journal of Anaesthesia, (doi: 10.1016/j.bja.2023.12.003) (PMID:38216388) (Early Online Publication)

Abstract

Background: Patients who have survive a burn injury might be at risk of opioid dependence after discharge. This study examined the use of opioids in patients who suffer burn injury and explored factors associated with persistent opioid use after hospital discharge. Methods: This retrospective cohort study compared adults admitted with a burn injury from 2009 to 2019 with two matched comparison cohorts from the general population and adults with a diagnosis of acute pancreatitis. Pre-admission prescription opioid use was determined, and a multivariable negative binomial regression analysis used to explore post-discharge opioid use. Results: A total of 7147 burn patients were matched with 6810 pancreatitis patients and with 28 184 individuals from the general population. Pre-admission opioid use was higher in the burn and pancreatitis cohorts (29% and 40%, respectively) compared with the general population (17%). Opioid use increased in both burn and pancreatitis cohorts after discharge (41% and 53%, respectively), although patients with pancreatitis were at even higher risk of increased opioid use in an adjusted analysis (incidence rate ratio 1.43). Female sex, lower socioeconomic status, ICU admission, pre-injury opioid use, and a history of excess alcohol use were all associated with an increase in opioid prescriptions after discharge. Conclusions: Opioid use is high in those admitted with a burn injury or acute pancreatitis when compared with the general population, increasing further after hospital discharge. Female sex and socioeconomic deprivation are among factors that make increased opioid use more likely, although this phenomenon seems even more pronounced in those with acute pancreatitis compared with burn injuries.

• Item Type: Articles
• Additional Information: This work has been supported by grants from the National Institute of Academic Anaesthesia (NIAA) Association of Anaesthetists research grant (Grant code: NIAA19R213); the NHS Greater Glasgow and Clyde Endowment Fund (Reference: GN19AE535); and the National Institute of Academic Anaesthesia (NIAA) Association of Anaesthetists John Snow Anaesthesia Intercalated Award.
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Quasim, Professor Tara and Puxty, Dr Kathryn and Shaw, Dr Martin and McGovern, Dr Christopher
• Authors: Jamal, S., Shaw, M., Quasim, T., Puxty, K., and McGovern, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: British Journal of Anaesthesia
• Publisher: Oxford University Press
• ISSN: 0007-0912
• ISSN (Online): 1471-6771
• Published Online: 11 January 2024
• Copyright Holders: Copyright: © 2023 The Author(s)
• First Published: First published in British Journal of Anaesthesia 2023
• Publisher Policy: Reproduced under a Creative Commons licence