Risk factors for opioid use disorder after severe burns in adults

Jana DeJesus, Nikhil R. Shah, Camila Franco-Mesa, Elliot T. Walters, Alen Palackic, Steven E. Wolf

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Risk factors for opioid dependence amongst burn patients have not been well-explored compared to other surgical fields. Methods: The TrinetX database was queried for patients diagnosed with opioid use disorder (OUD) after thermal or chemical burn. Propensity score matching was performed. Opioid and non-opioid analgesia use, ICU care, surgery, and comparative risks among common opiates were examined using descriptive and univariate regression models, including odds ratios. Subgroup analysis evaluated the impact of multimodal analgesia. Results: Odds of receiving IV opioids for acute analgesia (p = <0.0001, OR = 1.80, CI = 1.45–2.25), undergoing surgery (p = <0.0001, OR = 1.58, CI = 1.26–1.98), and ICU care (p = <0.0001, OR = 3.60, CI = 2.00–3.83) after burn injury were higher in patients who developed OUD. Patients receiving multimodal therapy within 24 hours of admission had lower odds of developing OUD (OR = 0.74, CI = 2.76–4.68, p = 0.0001) and chronic pain (OR = 0.89, CI = 0.78–1.00, p = 0.05) regardless of TBSA. Conclusion: Patients who developed opioid use disorder following burn injury had higher odds of receiving opioid exclusive pain management, more frequent surgery, ICU care.

Original languageEnglish (US)
Pages (from-to)400-407
Number of pages8
JournalAmerican Journal of Surgery
Volume225
Issue number2
DOIs
StatePublished - Feb 2023

Keywords

  • Burn
  • ICU
  • Multimodal
  • Opioid use disorder
  • Opioids
  • Pain

ASJC Scopus subject areas

  • Surgery

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