Does Pre-Op Opioid Use Influence Post-Op Outcomes?

(HealthDay News) — Preoperative opioid use is associated with increased health care utilization and costs after elective abdominal surgery, according to a study published in the April issue of the Annals of Surgery.

Jennifer F. Waljee, M.D., M.P.H., from the University of Michigan Health System in Ann Arbor, and colleagues identified 200,005 adult patients who underwent elective abdominal surgery from the Truven Health Marketscan Databases. After adjustment for number of comorbidities, psychological conditions, and demographic characteristics, the authors examined the impact of preoperative opioid use on postoperative health care utilization.

The researchers found that 8.8 percent of patients used opioids preoperatively. After adjustment for covariates, patients using opioids preoperatively were more likely to have a longer hospital stay (2.9 versus 2.5 days; P < 0.001) and to be discharged to a rehabilitation facility (3.6 versus 2.5 percent; P < 0.001) compared with nonusers. After adjustment for covariates, preoperative opioid use correlated with an increased rate of 30-day readmission (4.5 versus 3.6 percent; P < 0.001), and with overall increased expenditures at 90-, 180-, and 365-days after surgery ($12,036.60 versus $3,863.40; $16,973.70 versus $6,790.60; and $25,495.70 versus $12,113.80, respectively; all P < 0.001). Dose effects were seen for readmission, discharge destination, and late health care expenditures.

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“Preoperative interventions focused on opioid cessation and alternative analgesics may improve the safety and efficiency of elective surgery among chronic opioid user,” the authors write.

One author disclosed financial ties to 3M Health Information systems; a second author disclosed ties to Tonix Pharmaceuticals and Neuros Medical.

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