(311) Epidemiology of Opioid Use Disorder in Critically Ill Patients

Introduction: Opioid Use Disorder (OUD) affects over 40 million people worldwide. Patients with OUD have a higher incidence of intensive care unit (ICU) admissions than those without OUD. Factors like baseline demographics and underlying comorbidities must be considered when caring for these patients. Currently, there are no reliable large-scale data that describe the incidence of OUD in the critical care population. The purpose of this study was to characterize the epidemiology of diagnosed OUD in patients admitted to the ICU.

Methods: This study was a retrospective analysis of de-identified patient data from 2012-2022. Data were obtained using TriNetX, a research network with information from over 250,000,000 patients across 120 health care systems. The primary outcome was incidence of OUD in the ICU. Secondary outcomes were patient age, sex, race, incidence of comorbidities, rates of opioid and non-opioid pain medications used, and rates of medications for OUD (MOUD) in the OUD group only.

Results: A total of 2,133,465 patients were analyzed; 118,362 in the OUD group and 2,015,103 in the non-OUD group. Average incidence of OUD was 3.8% over the ten years. There was no difference in sex between the groups. The OUD group was on average 10 years younger than the non-OUC group with means of 53 years (SD 16) and 63 years (SD 20) respectively. The majority of both groups were white at 69% in the OUD group and 66% in the non-OUD group. Patients with OUD had higher incidence of several comorbidities, with the largest differences in nicotine dependence (70% vs 26%) anxiety (60% vs 29%), depressive episode (59% vs 29%), psychoactive substance disorder (56% vs 5.7%), and alcohol related disorders (40% vs 14%). Overall, the OUD group had higher use of opioids (44% vs 31%, p < 0.001) and non-opioid analgesics (38% vs 22%, p < 0.001). Methadone and buprenorphine were the most common MOUD used, both at 27% (p = 1.00). Of note, buprenorphine passed methadone in 2017 to become the most used MOUD.

Conclusions: This analysis demonstrates important differences in characteristics between OUD and non-OUD patients in the ICU, which should be taken into consideration for optimal patient care. This also confirms the need to analyze patient-specific outcomes in OUD in ICU, such as mortality and ICU length of stay.