Preoperative opioid, sedative, and antidepressant use is associated with increased postoperative hospital costs in colorectal surgery.

Autor: Jackson NA; Graduate Medical Education, General Surgery Residency Program, University of Kentucky, Lexington, KY, USA., Gan T; Graduate Medical Education, General Surgery Residency Program, University of Kentucky, Lexington, KY, USA., Davenport DL; Department of Surgery, University of Kentucky, Lexington, KY, USA., Oyler DR; Department of Surgery, University of Kentucky, Lexington, KY, USA.; Division of General Surgery, University of Kentucky, Lexington, KY, USA., Ebbitt LM; Department of Pharmacy Services, University of Kentucky, Lexington, KY, USA., Evers BM; Department of Surgery, University of Kentucky, Lexington, KY, USA.; Division of General Surgery, University of Kentucky, Lexington, KY, USA.; Markey Cancer Center, University of Kentucky, Lexington, KY, USA., Bhakta AS; Department of Surgery, University of Kentucky, Lexington, KY, USA. avinash.bhakta@uky.edu.; Division of General Surgery, University of Kentucky, Lexington, KY, USA. avinash.bhakta@uky.edu.; Section of Colorectal Surgery, University of Kentucky, Lexington, KY, USA. avinash.bhakta@uky.edu.; University of Kentucky Medical Center, 800 Rose St., C-233, Lexington, KY, 40536, USA. avinash.bhakta@uky.edu.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2021 Oct; Vol. 35 (10), pp. 5599-5606. Date of Electronic Publication: 2020 Oct 09.
DOI: 10.1007/s00464-020-08062-w
Abstrakt: Background: Opioid (OPD), sedative (SDT), and antidepressant (ADM) prescribing has increased dramatically over the last 20 years. This study evaluated preoperative OPD, SDT, and ADM use on hospital costs in patients undergoing colorectal resection at a single institution.
Methods: This study was a retrospective record review. The local ACS-NSQIP database was queried for adult patients (age ≥ 18 years) undergoing open/laparoscopic, partial/total colectomy, or proctectomy from January 1, 2013 to December 31, 2016. Individual patient medical records were reviewed to determine preoperative OPD, SDT, and AD use. Hospital cost data from index admission were captured by the hospital cost accounting system and matched to NSQIP query-identified cases. All ACS-NSQIP categorical patient characteristic, operative risk, and outcome variables were compared in medication groups using chi-square tests or Fisher's exact tests, and continuous variables were compared using Mann-Whitney U tests.
Results: A total of 1185 colorectal procedures were performed by 30 different surgeons. Of these, 27.6% patients took OPD, 18.5% SDT, and 27.8% ADM preoperatively. Patients taking OPD, SDT, and ADM were found to have increased mean total hospital costs (MTHC) compared to non-users (30.8 vs 23.6 for OPD, 31.6 vs 24.4 for SDT, and 30.7 vs 23.8 for ADM). OPD and SDT use were identified as independent risk factors for increased MTHC on multivariable analysis.
Conclusion: Preoperative OPD and SDT use can be used to predict increased MTHC in patients undergoing colorectal resections.
(© 2020. Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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