Postoperative duration of opioid use and acute healthcare services use in cancer patients hospitalized for thoracic surgery.

Autor: Kurteva S; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.; Clinical and Health Informatics Research Group, Department of Medicine, McGill University, Montreal, Quebec, Canada., Tamblyn R; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.; Clinical and Health Informatics Research Group, Department of Medicine, McGill University, Montreal, Quebec, Canada.; Department of Surgery, McGill University Health Center, Montreal, Quebec, Canada., Khosrow-Khavar F; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada., Meguerditchian AN; Clinical and Health Informatics Research Group, Department of Medicine, McGill University, Montreal, Quebec, Canada.; Department of Surgery, McGill University Health Center, Montreal, Quebec, Canada.; St. Mary's Research Institute, Montreal, Quebec, Canada.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2021 Sep; Vol. 124 (3), pp. 431-440. Date of Electronic Publication: 2021 Apr 24.
DOI: 10.1002/jso.26504
Abstrakt: Background: Postoperative pain control is an important cancer care component. However, opioid consumption has resulted in a surge of adverse events, with thoracic surgery patients having the highest rate of persistent use. The effect of opioid duration post-discharge and the risk of increased acute healthcare use in this population remains unclear.
Methods: A prospective cohort of non-metastatic cancer patients was assembled from an academic health center in Montreal (Canada). Clinical data linked to administrative claims from the universal healthcare program was used to determine the association between time-varying opioid patterns and emergency department (ED) visits/re-admissions/death 3 months following thoracic surgery.
Results: Of the 610 patients, 77% had at least one opioid dispensed post-discharge. Compared to non-opioid users, <15 days of use was associated with a 42% decreased risk of acute healthcare events, adjusted HR 0.58, 95% CI (0.40-0.85); longer durations were not associated with an increased risk. Compared to short-term use (<15 days), use of >30 days was associated with a 72% increased risk of the outcome, aHR: 1.72, 95% CI (1.01-2.93).
Conclusion: There was a variation in the risk of acute healthcare use associated with postsurgical opioid use. Findings from this study may be used to inform postoperative prescribing practices.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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