Trends in opioid use before critical illness among elderly patients in Ontario

Abstract Purpose To 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 methods We performed a population-based retrospective cohort study using health administrative database from the province of Ontario, Canada. We included all older adult (> 65 years) admissions to an ICU between April 2002 and March 2015. Our exposure was opioid use before admission categorized as chronic use, intermittent use, and non-use. Results The 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  Conclusions Among elderly ICU patients, opioid exposure prior to admission is prevalent and use is associated with higher in-hospital mortality.