Patterns and predictors of outpatient opioid use after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

Abstract

Background: Long-term opioid use is a well-known complication after surgery. In this retrospective study of adults who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), we sought to determine the rates and factors associated with outpatient opioid use within the sixth and twelfth postoperative months.

Methods: Records of 288 opioid-naïve patients were included. Logistic regression models were used to determine factors prognostic of outpatient opioid use.

Results: The median patient age was 54 years, and 63% were female. Rates of outpatient opioid use within the sixth and twelfth postoperative months were 21 and 13%, respectively. In the multivariate analysis, every doubling in the amount of in-hospital postoperative opioid consumption was associated with a 44% increase in odds of opioid use within the sixth postoperative month (OR 1.44, 95% CI 1.11–1.87, p = .006) and a 70% increase within the twelfth postoperative month (OR 1.70, 95% CI 1.70–2.37, p = .001). Other factors associated with opioid use within the sixth postoperative month included physical status (OR 5.26, 95% CI 1.08–25.55, p = .039) and recent additional surgery (OR 23.02, 95% CI 2.03–261.30, p = .011). Age (OR 4.39, 95% CI 1.77–10.89, p = .001) and tumor grade (OR 3.31, 95% CI 1.31–8.41, p = .012) were associated with opioid use within the twelfth postoperative month.

Conclusion: In this study, the amount of in-hospital postoperative opioid consumption was an important contributory factor to outpatient opioid use in the sixth and twelfth postoperative months.

Synopsis

• In this study of adults who had undergone CRS-HIPEC, higher postoperative opioid consumption during hospitalization was associated with higher odds of opioid use within the sixth and twelfth postoperative months.

Keywords:

• Outpatient
• long-term
• opioids
• cytoreduction
• surgery

Acknowledgments

Editorial support was provided by Bryan Tutt in Scientific Publications Services, Research Medical Library of The University of Texas MD Anderson Cancer Center.

Disclosure statement

The authors have no conflicts of interest.