uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Safety of benzodiazepines and opioids in very severe respiratory disease: national prospective study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
2014 (English)In: BMJ. British Medical Journal, ISSN 0959-535X, E-ISSN 1756-1833, Vol. 348, g445- p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2014. Vol. 348, g445- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-219963DOI: 10.1136/bmj.g445ISI: 000330647900012OAI: oai:DiVA.org:uu-219963DiVA: diva2:704584
Available from: 2014-03-12 Created: 2014-03-09 Last updated: 2014-03-12Bibliographically approved

Open Access in DiVA

fulltext(328 kB)132 downloads
File information
File name FULLTEXT01.pdfFile size 328 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Bornefalk-Hermansson, Anna
By organisation
UCR-Uppsala Clinical Research Center
In the same journal
BMJ. British Medical Journal
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 132 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 274 hits
ReferencesLink to record
Permanent link

Direct link