Migraine tied to higher odds of postop readmission for pain

  • Cephalalgia
  • 24 Jul 2018

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Surgical patients who develop migraines have a greater risk for pain-related readmission within 30 days of surgery compared with those without migraine.
  • The risk is greater among patients with migraine with aura.

Why this matters

  • Patients with migraine are particularly vulnerable to medication-overuse headache, and 64.6% of patients with migraine readmitted for pain in this study had received postoperative opioids. 

Study design

  • Hospital registry study of 150,710 patients (no migraine, n=138,942; migraine without aura, n=10,228; migraine with aura, n=1540) who underwent surgery.
  • Funding: None disclosed.

Key results

  • A statistically significant association seen between the diagnosis of migraine and 30-day readmission due to pain after surgery (aOR, 1.42; 95% CI, 1.15-1.75) vs no-migraine group.
  • A stronger association seen between migraine diagnosis and readmission in patients with migraine with aura (aOR, 2.20; 95% CI, 1.44-3.37) than those with migraine without aura (aOR, 1.30; 95% CI, 1.03-1.64) vs no migraine group.
  • Adjusted predicted probability of pain-related readmissions was 9.1 (95% CI, 5.3-13.0) in 1000 patients with migraine with aura and 5.4 (95% CI, 4.2-6.6) in migraine without aura vs no-migraine group.

Limitations

  • Risk for misdiagnosis of headache.

Coauthored with Anand Ramanathan, PharmD

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