Risk factors for opioid overdose among hospitalized patients

Abstract

Among hospitalized patients, risk factors of opioid overdose include age of 65 or greater, being in an ICU, renal impairment and concomitant administration of CNS depressant medications. These findings may help with the development and implementation of measures to prevent overdose.

An integrated LSTM-HeteroRGNN model for interpretable opioid overdose risk prediction

“…Some clusters (A, B) were highly interpretable in the context of feature cluster relationship to OD, such as clusters with multiple diagnoses related to accidental injury or substance/medication use or toxicity [51] , [52] . Other clusters (C), which we defined as intermediate in explainability, contained interpretable features related to clinical reno-pulmonary systems, which may be related to OD through mechanisms such as respiratory depression or impaired renal function [53] , [54] . Some clusters (D) did not have any clearly identifiable patterns with clinical meaning.…”

Protocol for community-driven selection of strategies to implement evidence-based practices to reduce opioid overdoses in the HEALing Communities Study: a trial to evaluate a community-engaged intervention in Kentucky, Massachusetts, New York and Ohio

“…The EBP strategies are required to include at least one to be implemented in each of the following three sectors: healthcare, behavioural health and criminal justice 18. Coalitions are encouraged to consider EBP strategies that would maximise impact in key populations most vulnerable to experiencing an opioid-involved overdose, including those who had a prior opioid overdose8 37–40; have reduced opioid tolerance (eg, completing medically supervised or socially managed withdrawal or release from institutional settings such as jail, residential treatment, hospital)40–44; use other substances (eg, alcohol, benzodiazepines, cocaine, and amphetamine like substances)40 45–49; have concomitant major mental50–53 or medical illness40 54–57 and/or inject drugs 46 58. Coalitions are also asked to prioritise venues through which these key populations are most likely to be reached.…”

The Opioid-overdose Reduction Continuum of Care Approach (ORCCA): Evidence-based practices in the HEALing Communities Study

“…Individuals who are at highest risk for overdose, such as those who have overdosed or those who recently were treated in a withdrawal management program (colloquially referred to as “detox”), do not typically access MOUD ( Larochelle et al, 2018 ; Walley et al, 2020 ). Specific factors that further elevate the risk of overdose among those using opioids include: 1) having had a prior opioid overdose ( Caudarella et al, 2016 ; Darke et al, 2011 ; Larochelle et al, 2018 ; Larochelle et al, 2019 ; Winhusen et al, 2016 ); 2) having reduced opioid tolerance (e.g., completing medically supervised or “socially” managed withdrawal, or release from an institutional setting such as jail, residential treatment, hospital) ( Binswanger et al, 2007 ; Larochelle et al, 2019 ; Merrall et al, 2010 ; Strang et al, 2003 ; Walley et al, 2020 ); 3) using other substances (e.g., alcohol, benzodiazepines, stimulants) ( Brugal et al, 2002 ; Cho et al, 2020 ; Gladden et al, 2019 ; Larochelle et al, 2019 ; Park et al, 2020 ; Park et al, 2015 ; Sun et al, 2017 ); 4) having a concomitant major mental illness (e.g., major depression, bipolar disorder, schizophrenia, anxiety disorders) ( O’Driscoll et al, 2001 ; Pabayo et al, 2013 ; Tobin and Latkin, 2003 ; Wines et al, 2007 ); 5) having a concomitant major medical illness (e.g., cirrhosis, chronic kidney disease, COPD, asthma, sleep apnea, congestive heart failure; infections related to drug use) ( Bosilkovska et al, 2012 ; Green et al, 2012 ; Jolley et al, 2015 ; Larochelle et al, 2019 ; Vu et al, 2018 ); and/or 6) injecting drugs ( Bazazi et al, 2015 ; Brugal et al, 2002 ).…”