Preoperative opioid use and postoperative pain associated with surgical readmissions.

Abstract

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.

• Authors: Elise A Dasinger, Laura A Graham, Tyler S Wahl, Joshua S Richman, Samantha J Baker, Mary T Hawn, Tina Hernandez-Boussard, Amy K Rosen, Hillary J Mull, Laurel A Copeland, Jeffrey C Whittle, Edith A Burns, Melanie S Morris
• Journal: American journal of surgery (Am J Surg) Vol. 218 Issue 5 Pg. 828-835 (11 2019) ISSN: 1879-1883 [Electronic] United States
• PMID: 30879796 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Chemical References

• Analgesics, Opioid

Topics

• Adult
• Aged
• Analgesics, Opioid (therapeutic use)
• Drug Utilization (statistics & numerical data)
• Female
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Opioid-Related Disorders (complications, diagnosis)
• Pain, Postoperative (drug therapy, etiology)
• Patient Readmission (statistics & numerical data)
• Preoperative Period
• Retrospective Studies
• Risk Factors
• United States
• Veterans Health