Perioperative Benzodiazepine Exposure Impacts Risk of New Persistent Benzodiazepine Use Among Patients with Cancer.

Autor: Rashid Z; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA., Woldesenbet S; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA., Khalil M; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA., Altaf A; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA., Shaw S; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA., Macedo AB; Department of Surgery, University of Santo Amaro, São Paulo, Brazil., Zindani S; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA., Catalano G; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA., Pawlik TM; Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. Tim.Pawlik@osumc.edu.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2024 Dec 28. Date of Electronic Publication: 2024 Dec 28.
DOI: 10.1245/s10434-024-16788-3
Abstrakt: Background: Benzodiazepines are the third most misused medication, with many patients having their first exposure during a surgical episode. We sought to characterize factors associated with new persistent benzodiazepine use (NPBU) among patients undergoing cancer surgery.
Patients and Methods: Patients who underwent cancer surgery between 2013 and 2021 were identified using the IBM-MarketScan database. NPBU was defined as one prescription filled during the 90-180 days period after surgery by patients who were previously benzodiazepine naïve. The association of variables with perioperative benzodiazepine use and NPBU was assessed using multivariable regression.
Results: Among 34,637 patients with cancer (breast: n = 5460, 15.8%; lung: n = 3479, 10.0%; esophagus: n = 384, 1.1%; gastric: n = 852, 2.5%; liver: n =502, 1.4%; biliary: n = 268, 0.8%; pancreas: n = 1290, 3.7%; colon: n = 10,838, 31.3%; rectum: n = 2566, 7.4%; prostate: n = 8998, 26.0%), most were male (n = 19,687, 56.8%) with a median age of 57 years (IQR 51-61 years). Overall, 8.8% of patients had perioperative benzodiazepine use and 7.5% of patients developed NPBU following surgery. On multivariable analyses, perioperative benzodiazepine exposure (ref. no perioperative exposure: OR 2.00, 95% CI 1.68-2.38) and higher perioperative dose of > 32.0 lorazepam milligram equivalents (LME) (ref. < 10 LME: OR 2.42, 95% CI 2.01-2.92) were independently associated with higher odds of NPBU. Notably, male patients had lower odds of NPBU versus female patients (OR 0.80, 95% CI 0.68-0.94).
Conclusions: Roughly 1 in 13 commercially insured patients developed NPBU following surgery for cancer. Judicious use of benzodiazepines among patients with high risk of misuse can mitigate NPBU to help avoid benzodiazepine-related complications such as overdose or accidental deaths.
Competing Interests: Disclosures: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors declare no funding or financial support. The authors declare no conflict of interest.
(© 2024. Society of Surgical Oncology.)
Databáze: MEDLINE
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