Table 6.

Adjusted HRs of death, discontinued dialysis, and hospitalization in 2011–2012 associated with 2010 prescription for ≥90 days of an opioid in the 2010 prevalent dialysis cohort (n=149,757)

CharacteristicsOutcome: DeathOutcome: Discontinued DialysisOutcome: Hospitalization
HR95% CIP ValueHR95% CIP ValueHR95% CIP Value
Opioid prescriptiona
 None1.001.001.00
 Short term1.051.02 to 1.07<0.0011.131.05 to 1.220.0021.131.11 to 1.14<0.001
 Chronic, <20 MME/d1.161.11 to 1.21<0.0011.321.15 to 1.53<0.0011.261.22 to 1.29<0.001
 Chronic, 20–50 MME/d1.261.22 to 1.30<0.0011.361.22 to 1.51<0.0011.291.27 to 1.32<0.001
 Chronic, 50+ MME/d1.391.34 to 1.44<0.0011.471.30 to 1.66<0.0011.381.35 to 1.41<0.001
Analgesic prescription
 No1.001.001.00
 Yes0.960.93 to 0.980.0010.940.85 to 1.030.161.031.02 to 1.05<0.001
Sex
 Women1.001.001.00
 Men1.111.09 to 1.13<0.0010.880.83 to 0.94<0.0010.950.94 to 0.96<0.001
Race
 White1.001.001.00
 Black0.820.80 to 0.83<0.0010.610.57 to 0.66<0.0010.960.95 to 0.98<0.001
 Other0.930.89 to 0.980.0020.660.56 to 0.78<0.0010.930.91 to 0.95<0.001
Age group, yr
 20–441.001.001.00
 45–641.781.71 to 1.85<0.0012.261.88 to 2.71<0.0011.051.03 to 1.06<0.001
 65+3.062.93 to 3.19<0.0016.835.70 to 8.19<0.0011.201.18 to 1.22<0.001
ESRD vintage, yr
 1–21.001.001.00
 3–41.141.11 to 1,18<0.0011.010.93 to 1.100.801.071.05 to 1.09<0.001
 5+1.291.26 to 1.33<0.0011.020.93 to 1.100.721.091.08 to 1.11<0.001
Dialysis modality
 HD1.001.001.00
 PD1.291.23 to 1.35<0.0011.211.06 to 1.400.011.161.13 to 1.19<0.001
History of kidney transplantation
 No1.001.001.00
 Yes0.880.84 to 0.93<0.0010.660.54 to 0.81<0.0010.990.97 to 1.010.37
Dual statusb
 No1.001.001.00
 Yes0.910.89 to 0.93<0.0010.750.70 to 0.81<0.0011.011.00 to 1.030.04
Residential area
 Large1.001.001.00
 Medium/small1.010.99 to 1.040.271.581.47 to 1.70<0.0010.960.95 to 0.98<0.001
 Nonmetropolitan1.111.08 to 1.13<0.0011.731.59 to 1.87<0.0010.920.91 to 0.93<0.001
Nursing home residencec
 No1.001.001.00
 Yes1.561.52 to 1.60<0.0012.242.07 to 2.42<0.0011.081.06 to 1.10<0.001
Cancerd
 No1.001.001.00
 Yes1.261.21 to 1.30<0.0011.401.26 to 1.55<0.0011.041.01 to 1.070.003
Prior pain-related hospitalization in 2010
 No1.001.001.00
 Yes0.950.92 to 0.990.010.970.86 to 1.100.661.161.13 to 1.18<0.001
No. of prior hospitalizations in 2010
 01.001.001.00
 1–21.551.52 to 1.59<0.0011.421.31 to 1.54<0.0011.561.54 to 1.58<0.001
 3–42.172.11 to 2.24<0.0011.851.67 to 2.04<0.0012.342.30 to 2.39<0.001
 5 or more3.052.95 to 3.15<0.0012.582.32 to 2.87<0.0013.633.55 to 3.71<0.001
Smoker
 No1.001.001.00
 Yes1.131.09 to 1.18<0.0011.261.11 to 1.42<0.0011.071.05 to 1.10<0.001
Congestive heart failure
 No1.001.001.00
 Yes1.201.17 to 1.23<0.0011.071.00 to 1.150.051.061.04 to 1.07<0.001
Peripheral vascular disease
 No1.001.001.00
 Yes1.081.05 to 1.11<0.0011.141.04 to 1.25<0.011.031.00 to 1.050.02
Cerebrovascular disease
 No1.001.001.00
 Yes1.030.99 to 1.070.101.291.17 to 1.43<0.0011.031.01 to 1.050.01
Chronic obstructive pulmonary disease
 No1.001.001.00
 Yes1.121.08 to 1.17<0.0011.110.99 to 1.240.081.131.10 to 1.15<0.001
Atherosclerotic heart disease
 No1.001.001.00
 Yes1.141.11 to 1.17<0.0011.060.98 to 1.150.141.071.05 to 1.09<0.001
Diabetes
 No1.001.001.00
 Yes1.181.15 to 1.20<0.0010.880.82 to 0.94<0.0011.131.12 to 1.14<0.001
AIDS
 No1.001.001.00
 Yes1.191.06 to 1.340.0031.240.76 to 2.000.391.121.06 to 1.19<0.001
  • a Short term: 1- to 89-day filled prescription supply within the study year; chronic: 90-day or more filled prescription supply within the study year.

  • b Dual status in Medicare and Medicaid.

  • c On the basis of one or more claims in physician/carrier files.

  • d On the basis of one or more inpatient stays with a cancer diagnosis and CMS Form 2728.