- Opioid use in hospitalized patients with sepsis is associated with significantly increased 28-day mortality.
Why this matters
- Higher circulating morphine levels in patients with sepsis/septic shock have been shown to promote disease progression by impairing gut barrier integrity, and mortality rates by increasing degree of immunosuppression.
- Judicious opioid use, coupled with alternative analgesic strategies in hospitalized patients with sepsis, is warranted.
- 5994 patients with sepsis were included; 4540 received opioids during hospitalization.
- Gram-negative bacterial infections were more common in opioid-treated vs -nontreated patients (31.26% vs 26.96%; P<.001).
- Gram-positive bacterial infections were also more common in opioid-treated vs -nontreated patients (39.32% vs 20.43%; P<.0001).
- Crude 28-day mortality rates for opioid-treated vs -nontreated patients was 10.35% vs 2.40%, respectively.
- Mortality rate difference remained significant after multivariate adjustment for age, sex, mean BMI, mean white blood cell count, comorbidity score, fungus presence, gram-positive/-negative bacteria presence, and positive microbial culture (HR, 6.239; 95% CI, 4.407-8.831; P<.0001).
- Retrospective cohort study evaluating effect of prescription opioid use in hospitalized patients with sepsis.
- Funding: NIH.
- None noted.