Preoperative opioid use tied to higher odds of pain-related readmission

  • Dasinger EA & al.
  • Am J Surg
  • 28 Feb 2019

  • International Clinical Digest
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Takeaway

  • Pain-related readmission within 30 days of discharge following surgery was more likely in patients with preoperative opioid use compared with opioid-naive patients, especially in patients who underwent general surgery.

Why this matters

  • Identifying which patients have a greater risk of readmission allows clinicians to implement interventions immediately following surgery to reduce readmission risk.

Study design

  • 176,989 patients underwent general, orthopedic, or peripheral vascular surgery in the Veteran’s Health Administration between October 2007 and September 2014.
  • Funding: VA Health Services.

Key results

  • Mean preoperative and postoperative pain scores were higher for patients with any preoperative opioid use compared with no use (4.1 vs 3.1; P<.001 and vs p respectively>
  • 30-day pain-related readmission was 1.5% overall and highest for patients with daily preoperative opioid use (2.5%), followed by frequent users (2.2%), infrequent users (1.7%), and opioid-naive patients (1.2%) (P<.001>
  • Overall, pain-related readmission was significantly more likely in patients with any preoperative opioid use (aOR, 1.31; 95% CI, 1.18-1.46).
  • Preoperative opioid use was associated with pain-related readmissions for general surgeries (OR, 1.37; 95% CI, 1.19-1.57), but not for vascular (OR, 1.28; 95% CI, 0.96-1.71) and orthopedic surgeries (OR, 0.96; 95% CI, 0.78-1.19).

Limitations

  • Retrospective study, all-veteran cohort.

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