Subdural haemorrhage is associated with recent morphine treatment in patients with cancer: A retrospective population-based nested case-control study

Posted online on June 2, 2014.

Cynthia Wei-Sheng Lee¹, Chih-Hsin Muo², Ji-An Liang^3,4, Fung-Chang Sung², & Chia-Hung Kao^3,5

¹Center for Drug Abuse and Addiction, China Medical University Hospital and China Medical University,

Taichung

, Taiwan,

²Management Office for Health Data, China Medical University Hospital,

Taichung

, Taiwan,

³Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University,

Taichung

, Taiwan, and

⁴Department of Radiation Oncology,

⁵Department of Nuclear Medicine and PET Center, China Medical University Hospital,

Taichung

, Taiwan

Correspondence:

Chia-Hung Kao, MD

, Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University,

No. 2, Yuh-Der Road, Taichung 40447

, Taiwan. Tel: +886-4-22052121 ext.7412. Fax: +886-4-22336174. E-mail: d10040@mail.cmuh.org.tw, dr.kaochiahung@gmail.com

Abstract

Background: This study investigated the relationship between recent morphine use and risk of subdural haemorrhage (SDH) in patients with cancer.
Methods: This study identified a malignancy cohort of 25 322 patients who had never received morphine treatment. In this malignancy cohort, 200 patients who subsequently developed SDH were designated as the SDH group. Control-group patients without SDH were selected from the malignancy cohort and were matched ∼4:1 to each SDH case for age, sex, year of cancer diagnosis and index year. Morphine use was designated as ‘recent’ if the prescription duration covered the index date or ended within 6 months before the index date. Logistic regression was used to estimate odds ratios and 95% confidence intervals and a multivariable model was applied to control for age, sex and cerebrovascular disease.
Results: Compared with non-morphine users, patients with cancer who received morphine within 6 months of the index date exhibited a 2.58-fold (95% CI = 1.23–5.39) increase in the risk of developing SDH. The risk of SDH development increased as the duration of morphine treatment increased.

Conclusion: The incidence of SDH in patients with cancer in Taiwan is associated with recent morphine treatment (≤6 months) and is dependent on the duration of morphine use.

Keywords

International Classification of Diseases, Longitudinal Health Insurance Database, malignancy, morphine, National Health Insurance Research Database, subdural haemorrhage

Read More: http://informahealthcare.com/doi/abs/10.3109/02699052.2014.910836