Association Between Opioid Use Disorder and Hysterectomy Outcomes

Area of Science:

• Gynecologic Surgery
• Addiction Medicine
• Health Services Research

Background:

• Opioid use disorder (OUD) is a growing public health concern impacting various medical procedures.
• Hysterectomy, a common gynecologic surgery, may have different outcomes in patients with OUD.

Purpose of the Study:

• To investigate the association between opioid use disorder (OUD) and postoperative complications, length of stay, and hospital charges following hysterectomy.
• To compare outcomes for patients with and without OUD undergoing both inpatient and outpatient hysterectomy.

Main Methods:

• Retrospective cohort study utilizing the Nationwide Ambulatory Surgery Sample and National Inpatient Sample databases (2016-2021).
• Inclusion of adult patients undergoing various types of hysterectomy (open, laparoscopic, robotic, vaginal) for benign and malignant indications.
• Analysis using survey-weighted regression models, adjusting for demographics and comorbidities, to assess complication rates, length of stay, and hospital charges.

Main Results:

• Patients with OUD undergoing outpatient hysterectomy showed a slightly higher complication rate (3.8% vs. 3.4%) but similar charges compared to those without OUD.
• In the inpatient cohort, patients with OUD experienced significantly higher complication rates (14.7% vs. 11.8%), longer lengths of stay (4.3 vs. 3.2 days), and increased hospital charges ($91,258 vs. $71,809).
• The study analyzed data from over 1.6 million outpatient and 188,000 inpatient procedures.

Conclusions:

• Patients with opioid use disorder (OUD) are at an elevated risk for postoperative complications following hysterectomy, regardless of surgical setting.
• OUD is associated with increased length of stay and higher hospital costs for inpatient hysterectomy patients.
• Preoperative optimization and patient education may be crucial for improving outcomes in patients with OUD undergoing hysterectomy.