Epidemiology and Outcomes Associated with New Persistent Opioid Use after Transabdominal Surgery

Area of Science:

• Surgical outcomes research
• Pharmacovigilance
• Public health

Background:

• Persistent opioid use affects 3-12% of opioid-naive patients post-surgery.
• The link between persistent opioid use and adverse outcomes after transabdominal surgery is not well-defined.
• This study investigates the association between new persistent opioid use and long-term mortality and readmission rates.

Purpose of the Study:

• To assess the association between new persistent opioid use and long-term mortality after transabdominal surgery.
• To evaluate the association between new persistent opioid use and readmission rates within 3-6 months post-surgery.
• To analyze the impact of persistent opioid use on surgical outcomes in opioid-naive patients.

Main Methods:

• A cohort of 3,923 opioid-naive patients undergoing transabdominal surgery (laparoscopy or laparotomy) was analyzed.
• Persistent opioid use was defined as use beyond 3 months postoperatively.
• Propensity-weighted regression models were used to compare long-term mortality and readmission rates between patients with and without persistent opioid use.

Main Results:

• New persistent opioid use was identified in 13% of patients.
• Persistent opioid use was significantly associated with increased long-term mortality (HR 1.84) and readmission rates (OR 3.24).
• A dose-response relationship was observed, with higher opioid consumption correlating with worse outcomes.

Conclusions:

• New persistent opioid use following transabdominal surgery is a significant risk factor for increased mortality and readmission.
• Enhanced postoperative support and improved care transitions are crucial for patients at risk of persistent opioid use.
• These findings underscore the importance of monitoring and managing opioid use post-surgery to mitigate adverse long-term outcomes.