Wednesday, March 12, 2014

After Major Surgery, Who is at Risk for Prolonged Opiod Use?

This population based retrospective cohort study of acute care hospitals in Ontario, Canada looked at almost 40,000 opioid naive patients over age 65 who underwent major elective surgery. They looked at the outcome of prolonged opioid use after discharge. They found that 3.1% continued to receive opioids for more than 90 days after surgery. Factors associated with an increased risk of prolonged opioid use included:
  • younger age
  • lower household income
  • specific comorbidities (diabetes, heart failure, pulmonary disease)
  • preoperative use of  benzodiazepines, selective serotonin reuptake inhibitors, angiotensin converting enzyme inhibitors)
  • Thoracic procedures compared to open radical prostatectomies
On the flip side, open and minimally invasive major gynecological procedures were associated with significantly lower risks.

BMJ. 2014;348:g1251

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