The following is a summary of “Hospital Opioid Usage and Adverse Events in Patients With End-Stage Liver Disease,” published in the APRIL 2023 issue of Pain Management by Johnson, et al.
For a study, researchers investigated the use of opioids in end-stage liver disease (ESLD) patients and whether there was an association between opioid use and adverse events (AEs) in these patients. In addition, they aimed to compare outcomes in patients who received opioids to those who did not and identify risk factors for AEs.
The study was conducted as a retrospective case-cohort analysis of 270 hospitalized patients with ESLD and used administrative and clinical data from electronic medical records.
Results showed that two-thirds of patients admitted during the study period received at least one opioid analgesic. Patients who received opioids had more liver-related complications and higher rates of anxiety (32% vs. 17%, P= 0.007). They also had significantly worse initial and average pain scores (P< 0.001) and received more palliative care consultations. While the opioid group had somewhat more respiratory (22.2% vs. 11.1%, P= 0.02) and gastrointestinal (38.5% vs. 25.2%, P= 0.03) AEs, there was no increase in CNS adverse events which included hepatic encephalopathy.
Furthermore, the study found that anxiety and disease severity, indicated by the number of liver-related complications, were risk factors for AEs. In contrast, opioid administration was not an independent risk factor. They concluded that opioids have an appropriate and reasonably safe role in alleviating pain in patients with ESLD.
Reference: jpsmjournal.com/article/S0885-3924(22)01002-8/fulltext