Safety of benzodiazepines and opioids in very severe respiratory disease: national prospective study

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Safety of benzodiazepines and opioids in very severe respiratory disease : national prospective study

Ekström, Magnus (författare): Lund University,Lunds universitet,Lungmedicin, allergologi och palliativ medicin,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Andfåddhet och kronisk andningssvikt,Forskargrupper vid Lunds universitet,Respiratory Medicine, Allergology, and Palliative Medicine,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Breathlessness and chronic respiratory failure,Lund University Research Groups

Bornefalk-Hermansson, Anna (författare): Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)

Abernethy, Amy P. (författare)

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Currow, David C. (författare)

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2014-01-30
2014
Engelska.
Ingår i: The BMJ. - : BMJ. - 1756-1833. ; 348, s. g445-

Relaterad länk:: https://uu.diva-port... (primary) (Raw object); visa fler...; https://www.bmj.com/...; https://portal.resea... (primary) (free); http://www.ncbi.nlm....; http://dx.doi.org/10... (free); https://urn.kb.se/re...; https://doi.org/10.1...; https://lup.lub.lu.s...; visa färre...

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Objective To evaluate the safety of benzodiazepines and opioids in patients with very severe chronic obstructive pulmonary disease (COPD). Design Population based longitudinal consecutive cohort study. Setting Centres prescribing long term oxygen therapy in Sweden. Patients 2249 patients starting long term oxygen therapy for COPD in Sweden between 2005 and 2009 in the national Swedevox Register. Main outcome measures Effects of benzodiazepines and opioids on rates of admission to hospital and mortality, adjusted for age, sex, arterial blood gases, body mass index (BMI), performance status, previous admissions, comorbidities, and concurrent drugs. Results 1681 (76%) patients were admitted to hospital, and 1129 (50%) died under observation. No patient was lost to follow-up. Benzodiazepines and opioids were not associated with increased admission: hazard ratio 0.98 (95% confidence interval, 0.87 to 1.10) and 0.98 (0.86 to 1.10), respectively. Benzodiazepines were associated with increased mortality (1.21, 1.05 to 1.39) with a dose response trend. Opioids also had a dose response relation with mortality: lower dose opioids (<= 30 mg oral morphine equivalents a day) were not associated with increased mortality (1.03, 0.84 to 1.26) in contrast with higher dose opioids (1.21, 1.02 to 1.44). Concurrent benzodiazepines and opioids in lower doses were not associated with increased admissions (0.86, 0.53 to 1.42) or mortality (1.25, 0.78 to 1.99). Associations were not modified by being naive to the drugs or by hypercapnia. Conclusions Lower dose opioids are not associated with increased admissions or deaths in patients with COPD and might be safe for symptom reduction in severe respiratory disease.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)

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Av författaren/redakt...: Ekström, Magnus; Bornefalk-Herman ...; Abernethy, Amy P ...; Currow, David C.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Lungmedicin och ...

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Av lärosätet: Uppsala universitet; Lunds universitet

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