Survival implications of prescription opioid and benzodiazepine use in lung transplant recipients: Analysis of linked transplant registry and pharmacy fill records.


Journal

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
ISSN: 1557-3117
Titre abrégé: J Heart Lung Transplant
Pays: United States
ID NLM: 9102703

Informations de publication

Date de publication:
06 2021
Historique:
received: 21 07 2020
revised: 28 01 2021
accepted: 04 02 2021
pubmed: 14 4 2021
medline: 1 2 2022
entrez: 13 4 2021
Statut: ppublish

Résumé

Prescription opioid and benzodiazepine use have been associated with morbidity and mortality among some groups of solid organ transplant recipients, but implications for outcomes among lung transplant patients are not well described. We conducted a retrospective cohort study using linked national transplant registry and pharmaceutical records to characterize the associations between benzodiazepine and opioid prescription fills in the years before and after lung transplant (2006-2017), with risk-adjusted posttransplant survival (adjusted hazard ratio, Among 11,568 recipients, 33.7% filled an opioid prescription, and 25.8% filled a benzodiazepine prescription before transplant. Compared to patients without prescriptions, those who filled both short- and long-acting benzodiazepine prescriptions before transplant had 2-fold higher mortality in the first year posttransplant (aHR, Benzodiazepine prescription fills before and after lung transplant, and opioid fills after transplant, are independently associated with posttransplant mortality. Review of benzodiazepine and opioid use history is relevant to risk-stratifying patients before and after lung transplant.

Sections du résumé

BACKGROUND
Prescription opioid and benzodiazepine use have been associated with morbidity and mortality among some groups of solid organ transplant recipients, but implications for outcomes among lung transplant patients are not well described.
METHODS
We conducted a retrospective cohort study using linked national transplant registry and pharmaceutical records to characterize the associations between benzodiazepine and opioid prescription fills in the years before and after lung transplant (2006-2017), with risk-adjusted posttransplant survival (adjusted hazard ratio,
RESULTS
Among 11,568 recipients, 33.7% filled an opioid prescription, and 25.8% filled a benzodiazepine prescription before transplant. Compared to patients without prescriptions, those who filled both short- and long-acting benzodiazepine prescriptions before transplant had 2-fold higher mortality in the first year posttransplant (aHR,
CONCLUSIONS
Benzodiazepine prescription fills before and after lung transplant, and opioid fills after transplant, are independently associated with posttransplant mortality. Review of benzodiazepine and opioid use history is relevant to risk-stratifying patients before and after lung transplant.

Identifiants

pubmed: 33846078
pii: S1053-2498(21)02177-X
doi: 10.1016/j.healun.2021.02.004
pmc: PMC8169588
mid: NIHMS1692791
pii:
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Multicenter Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

513-524

Subventions

Organisme : NIDDK NIH HHS
ID : R01 DK120518
Pays : United States

Informations de copyright

Copyright © 2021 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

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Auteurs

Krista L Lentine (KL)

Saint Louis Transplant Center, St. Louis, Missouri, USA. Electronic address: krista.lentine@health.slu.edu.

Paolo R Salvalaggio (PR)

Hospital Israelita Albert Einstein, Sao Paulo, Brazil.

Yasar Caliskan (Y)

Saint Louis Transplant Center, St. Louis, Missouri, USA.

Ngan N Lam (NN)

University of Calgary, Calgary, Alberta, Canada.

Mara McAdams-DeMarco (M)

Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

David Axelrod (D)

University of Iowa, Iowa City, Iowa, USA.

Dorry L Segev (DL)

Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

Larissa Myaskovsky (L)

University of New Mexico, Albuquerque, New Mexico, USA.

Mary Amanda Dew (MA)

University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Heather Bruschwein (H)

University of Virginia School of Medicine, Charlottesville, Virginia, USA.

Deborah J Levine (DJ)

University of Texas, San Antonio, Texas, USA.

Stuart Sweet (S)

Washington University, St. Louis, Missouri, USA.

Gregory P Hess (GP)

Drexel University, Philadelphia, Pennsylvania, USA.

Bertram L Kasiske (BL)

Hennepin County Medical Center, Minneapolis, Minnesota, USA.

Mark A Schnitzler (MA)

Saint Louis Transplant Center, St. Louis, Missouri, USA.

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Classifications MeSH