University of Florida College of Medicine-Jacksonville, Jacksonville, Florida.
University of Florida College of Medicine, Gainesville, Florida.
Pain Med. 2021 Sep 8;22(9):2100-2105. doi: 10.1093/pm/pnab047.
Using the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) in patients returning to the emergency department (ED) for pain and discharged with an opioid prescription, we assessed overall opioid overdose risk and compared risk in opioid naive patients to those who are non-opioid naive.
This was a secondary analysis from a prospective observational study of patients ≥ 18 years old returning to the ED within 30 days. Data were collected from patient interviews and chart reviews. Patients were categorized as Group 1 (not using prescription opioids) or Group 2 (consuming prescription opioids). Statistical analyses were performed using Fisher's exact and Wilcoxon's rank sum tests. Risk class and probability of overdose was determined using Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD).
Of the 389 enrollees who returned to the ED due to pain within 30 days of an initial visit, 67 (17%) were prescribed opioids. The majority of these patients were in Group 1 (60%). Both Group 1 (n = 40) and Group 2 (n = 27) held an average CIP-RIOSORD risk class of 3. Race significantly differed between groups; the majority of Group 1 self-identified as African American (80%) (P = .0267). There were no differences in age, gender, or CIP-RIOSORD risk class between groups. However, Group 2 had nearly double the number of predictive factors (median = 1.93) as Group 1 (median = 1.18) (P = .0267).
A substantial proportion of patients (25%) were high risk for opioid overdose. CIP-RIOSORD may prove beneficial in risk stratification of patients discharged with prescription opioids from the ED.
使用风险指数（CIP-RIOSORD）评估因疼痛返回急诊科（ED）并开具阿片类药物处方后出院的患者的总体阿片类药物过量风险，并比较阿片类药物初治患者与非阿片类药物初治患者的风险。
这是一项对 30 天内返回 ED 的≥18 岁患者进行的前瞻性观察性研究的二次分析。数据来自患者访谈和病历回顾。患者分为第 1 组（未使用处方阿片类药物）或第 2 组（使用处方阿片类药物）。使用 Fisher 确切检验和 Wilcoxon 秩和检验进行统计学分析。使用风险指数（CIP-RIOSORD）确定风险等级和过量风险概率。
在 389 名因初始就诊后 30 天内疼痛返回 ED 的患者中，67 名（17%）开具了阿片类药物。这些患者大多属于第 1 组（60%）。第 1 组（n=40）和第 2 组（n=27）的平均 CIP-RIOSORD 风险等级均为 3 级。两组之间种族存在显著差异；第 1 组大多数自我认定为非裔美国人（80%）（P=.0267）。两组在年龄、性别或 CIP-RIOSORD 风险等级方面无差异。然而，第 2 组的预测因素数量几乎是第 1 组的两倍（中位数=1.93）（中位数=1.18）（P=.0267）。
相当一部分患者（25%）存在阿片类药物过量的高风险。CIP-RIOSORD 可能有助于对从 ED 开具处方阿片类药物出院的患者进行风险分层。
