Preoperative opioid use and its association with postoperative complications

ABSTRACT

Background

The negative impact of opioid use in the U.S. has led providers to seek alternative methods for pain control. More specifically, preoperative opioid usage has been demonstrated to adversely affect patients and clinical outcomes. This study aims to assess the extent of the relationship between preoperative opioid use on postoperative outcomes across surgical disciplines using statewide population databases.

Methods

The study used the Utah All Payers Claims Database and Utah Population Database to identify a cohort of adult patients who underwent a single surgery between 2013 and 2016 and had continuous insurance enrollment. Preoperative opioid prescription within one year prior to the index surgery was the independent variable, while complications and hospital admissions one year following the index surgery were the primary outcomes.

Results

Our model of 18,647 patients found that the odds of any complication with preoperative opioid use was 1.28. Depression (OR 1.17) and drug misuse (OR 1.41) were also associated with a higher risk of postoperative complications. Rates of hospital readmission in the preoperative opioid use group compared to the opioid naïve group were increased (19.43% vs. 12.44%, p < .01).

Conclusion

The data can be used to guide patient-physician conversations and better inform prescribing habits perioperatively.

KEYWORDS:

• Opioid use
• postoperative complications

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data is not publicly available. To access to the database, it is required to have approval from Utah Population Database which can be accessed through the following link: https://uofuhealth.utah.edu/huntsman/utah-population-database.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14659891.2024.2351016

Additional information

Funding

Partial support for all datasets within the Utah Population Database was provided by the University of Utah Huntsman Cancer Institute and the Huntsman Cancer Institute Cancer Center Support grant [grant number P30 CA2014] from the National Cancer Institute. The research reported in this publication was also supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number(s) [UM1TR004409]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.