High-dose opioid utilization and mortality among individuals initiating hemodialysis

BMC Nephrology

Table 4 Risk of mortality associated with opioid dose among adults initiating hemodialysis, 2007–2014^a (N = 327,344)

Dose (MME per day)	HR (95% CI)	p-value	p-value for trend
No opioids	REF	–	< 0.0001
1 to < 30	0.88 (0.85, 0.90)	< 0.0001
30 to <60	0.98 (0.95, 1.01)	0.1162
60 to < 90	1.30 (1.25, 1.34)	< 0.0001
90 to < 120	1.29 (1.22, 1.36)	< 0.0001
≥ 120	1.63 (1.57, 1.69)	< 0.0001

^aCox proportional hazard model with time varying exposure for dose and adjustment for patient age, race, ethnicity, sex, employment status, cause of ESKD, body mass index, comorbid conditions (diabetes, cerebrovascular, arteriosclerotic heart disease, peripheral vascular, hypertension, chronic heart failure, chronic obstructive pulmonary, tobacco use, cancer, drug use, inability to ambulate, needs assistance, institutionalized, no prior comorbidities), Charlson comorbidity index, U.S. region, ESKD network, dual-eligible status for Medicare and Medicaid, incident year of hemodialysis, and cumulative days on opioids

ISSN: 1471-2369