Preoperative opioid use and postoperative pain associated with surgical readmissions. Am J Surg 2019 Nov;218(5):828-835
Date
03/19/2019Pubmed ID
30879796DOI
10.1016/j.amjsurg.2019.02.033Scopus ID
2-s2.0-85062900533 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
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.
Author List
Dasinger EA, Graham LA, Wahl TS, Richman JS, Baker SJ, Hawn MT, Hernandez-Boussard T, Rosen AK, Mull HJ, Copeland LA, Whittle JC, Burns EA, Morris MSAuthor
Jeffrey Whittle MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Analgesics, Opioid
Drug Utilization
Female
Humans
Male
Middle Aged
Multivariate Analysis
Opioid-Related Disorders
Pain, Postoperative
Patient Readmission
Preoperative Period
Retrospective Studies
Risk Factors
United States
Veterans Health
