Dataset Information

Opioid use prior to elective surgery is strongly associated with persistent use following surgery: an analysis of 14?354 Medicare patients.

ABSTRACT:

Background

Persistent opioid use following total joint replacement (TJR) surgery is common; however, the association between pre-surgical opioid use and surgery type has not been established. The objective of this study was to determine the association between pre-surgery opioid use and persistent post-surgery opioid use in TJR patients compared to other elective surgical patients.

Methods

This is a retrospective cohort study, of univariate and multinomial logistic regression of linked, de-identified Medicare Benefits Schedule and Pharmaceutical Benefits Schedule data, adjusted for perioperative opioid use, age and sex. Oral morphine equivalents daily doses (OMEDD) were calculated and opioid use was categorized into three mutually exclusive categories for each observation window: low (0-5 OMEDD), moderate (5-10 OMEDD), high (10+ OMEDD). Persistent opioid use was defined as opioid use between 180 and 270?days after the date of surgery.

Results

Persistent opioid use was associated with older age, female gender and pre-surgery opioid use. There was no increased risk for persistent opioid use for TJR patients compared to other surgical patients. The intensity of pre-surgery opioid usage is strongly associated with persistent opioid use in all observed surgical patients.

Conclusions

Our results suggest that many patients who use opioids prior to surgery will persist in their opioid use following surgery. No association was found between persistent opioid use and TJR surgery, but rather a risk reduction compared to other elective surgeries when associations with opioid use are controlled for. Primary care clinicians and surgeons should monitor the duration and dosage of perioperative opioid use.

SUBMITTER: Catchpool M

PROVIDER: S-EPMC6900005 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Publications

Opioid use prior to elective surgery is strongly associated with persistent use following surgery: an analysis of 14 354 Medicare patients.

Catchpool Max M Knight Josh J Young Jesse T JT Clarke Philip P Barrington Michael J MJ Choong Peter F M PFM Dowsey Michelle M MM

ANZ journal of surgery 20191021 11

<h4>Background</h4>Persistent opioid use following total joint replacement (TJR) surgery is common; however, the association between pre-surgical opioid use and surgery type has not been established. The objective of this study was to determine the association between pre-surgery opioid use and persistent post-surgery opioid use in TJR patients compared to other elective surgical patients.<h4>Methods</h4>This is a retrospective cohort study, of univariate and multinomial logistic regression of l ...[more]

PMID: 31637832

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