Preoperative opioid use and postoperative pain associated with surgical readmissions - 17/10/19
, Laura A. Graham c, d, Tyler S. Wahl a, b, Joshua S. Richman a, b, Samantha J. Baker a, b, Mary T. Hawn c, d, Tina Hernandez-Boussard d, Amy K. Rosen e, f, Hillary J. Mull e, f, Laurel A. Copeland g, h, Jeffrey C. Whittle i, j, Edith A. Burns i, j, Melanie S. Morris a, bAbstract |
Background |
The extent of preoperative opioid utilization and the relationship with pain-related readmissions are not well understood.
Methods |
VA Surgical Quality Improvement Program data on general, vascular, and orthopedic surgeries (2007–2014) were merged with pharmacy data to evaluate preoperative opioid use and pain-related readmissions. Opioid use in the 6-month preoperative period was categorized as none, infrequent, frequent, and daily.
Results |
In the six-month preoperative period, 65.7% had no opioid use, 16.7% had infrequent use, 6.3% frequent use, and 11.4% were daily opioid users. Adjusted odds of pain-related readmission were higher for opioid-exposed groups vs the opioid-naïve group: infrequent (OR 1.17; 95% CI:1.04–1.31), frequent (OR 1.28; 95% CI:1.08–1.52), and daily (OR 1.49; 95% CI:1.27–1.74). Among preoperative opioid users, those with a pain-related readmission had higher daily preoperative oral morphine equivalents (mean 44.5 vs. 36.1, p < 0.001).
Conclusions |
Patients using opioids preoperatively experienced higher rates of pain-related readmissions, which increased with frequency and dosage of opioid exposure.
Le texte complet de cet article est disponible en PDF.Highlights |
• | History of opioid use in the 6-month preoperative period was associated with higher rates of readmissions related to pain. |
• | This association was dependent on the frequency and dosage of preoperative opioid exposure. |
• | The risk for pain-related readmissions varied by surgical specialty. |
Keywords : Opioid, Surgery, Readmissions, Postoperative pain, Preoperative opioid, Veterans
Plan
Vol 218 - N° 5
P. 828-835 - novembre 2019 Retour au numéro
Article précédent
- Association of new opioid continuation with surgical specialty and type in the United States
- Mark C. Bicket, Irene B. Murimi, Omar Mansour, Christopher L. Wu, G. Caleb Alexander
- Prolonged operating room time in emergency general surgery is associated with venous thromboembolic complications
- Joseph V. Sakran, Hiba Ezzeddine, Elliott R. Haut, Nicole Lunardi, Ambar Mehta, Rachel L. Choron, Jennifer Reid, Muhammad Zeeshan, Mohammad Hamidi, Bellal A. Joseph
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?