Lung cancer: 14% develop chronic opioid use postresection

  • Brescia AA & al.
  • Ann Thorac Surg
  • 1 Feb 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • 14% of opioid-naive patients with lung cancer became persistent opioid users after lung resection.
  • Patients who underwent thoracotomy were nearly 60% more likely to become persistent opioid users compared with those who underwent video-assisted thoracoscopic surgery (VATS).

Why this matters

  • Studies suggest that elective surgery is a risk factor for persistent opioid use, but little is known about the incidence after lung resection.

Study design

  • 3026 opioid-naive patients underwent lung resection.
  • Funding: None disclosed.

Key results

  • 6.5% of patients underwent postoperative neoadjuvant therapy, and 21.7% underwent postoperative adjuvant therapy.
  • 56.9% underwent thoracotomy, 41.1% underwent VATS, and surgical approach was unknown in 2.0%.
  • 14% of total cohort continued to fill opioid prescriptions 90-180 days after surgery.
  • 17.1% of thoracotomy patients persistently used opioids vs 9.4% of VATS patients (P<.001>
  • 23.9% of adjuvant therapy patients became persistent opioid users vs 11.4% of those who did not undergo adjuvant therapy (P<.001>
  • After multivariable analysis, independent patient risk factors for persistent opioid use included age ≤64 years (OR, 1.30; 95% CI, 1.05-1.62), male sex (OR, 1.39; 95% CI, 1.12-1.72), postoperative length of stay >5 days (OR, 1.30; 95% CI, 1.04-1.63), adjuvant therapy (OR, 2.19; 95% CI, 1.74-2.75), and thoracotomy (OR, 1.58; 95% CI, 1.24-2.01).

Limitations

  • Retrospective study.

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