title: Opioid overdose leading to intensive care unit admission: Epidemiology and outcomes.
abstract: There is a scarcity of studies assessing the patient population admitted to the intensive care unit (ICU) with opioid overdose. We sought to characterize the epidemiologic features and outcomes of this patient population.
  
  
  
  This is a retrospective cohort study of adult patients admitted to the ICU at University of Louisville Hospital for opioid overdose. We reviewed each patient's hospital record for demographic data, comorbidities, opioid used, coingestions, and outcomes.
  
  
  
  We included 178 adult patients, of which 107 (60%) were females. The median age was 41 years (interquartile range [IQR], 23). Oxycodone and hydrocodone were the 2 most commonly abused opioids. Benzodiazepines were the most common drug coingested, followed by amphetamines. Tobacco smoking, chronic pain, and alcoholism were the most frequent comorbidities identified. Mental disorders were also common. Most patients required invasive mechanical ventilation (84.8%). Median ICU length of stay was 3 days. Eighteen patients (10.1%) died in the hospital, whereas 6 patients (3.4%) were discharged to a nursing home. Patients who had any coingestion were significantly more likely to undergo invasive mechanical ventilation (91% vs 77%; P=.014) and had longer ICU length of stay (3 [IQR, 2] vs 2 [IQR, 1.8] days; P=.024).
  
  
  
  Opioid overdose is a common cause of ICU admission and affects a relatively young population. Most have respiratory failure requiring mechanical ventilation. It is associated with a relatively high inhospital mortality. Coingestions appear to have an impact on outcomes.
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Louisville, Louisville, KY.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Pfister
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Louisville, Louisville, KY.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Burkes
authors.affiliation: Division of Infectious Diseases, University of Louisville, Louisville, KY.
authors.forename: Brian
authors.initials: B
authors.lastname: Guinn
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Louisville, Louisville, KY.
authors.forename: Jacquelene
authors.initials: J
authors.lastname: Steele
authors.affiliation: Division of Infectious Diseases, University of Louisville, Louisville, KY.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Kelley
authors.affiliation: Division of Infectious Diseases, University of Louisville, Louisville, KY.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Wiemken
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Louisville, Louisville, KY.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Saad
authors.affiliation: Division of Infectious Diseases, University of Louisville, Louisville, KY.
authors.forename: Julio
authors.initials: J
authors.lastname: Ramirez
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Louisville, Louisville, KY.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Cavallazzi
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000506:poisoning*; D015331:Cohort Studies; D003422:Critical Care; D062787:Drug Overdose / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007629:Kentucky / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D010343:Patient Admission; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: Drug abuse; Intensive care unit; Mechanical ventilation; Mortality; Opioid; Overdose