In this large cohort of Medicare recipients, the safety of opiates was compared; using a reference of hydrocodone, codeine and oxycodone were associated with significant higher 30 day rates of mortality, and tramadol was associated with significantly lower 30 day rates of fractures and safety events requiring hospitalization. Codeine also had higher rates of cardiovascular events than hydrocodone at 180 days. This large cohort suggests that for major safety outcomes, tramadol and hydrocodone are significantly safer than codeine and oxycodone (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.