Opioid use disorder (OUD) is tied with more complications and increased Length of stay after major abdominal surgery, according to a recent study published in the annals of surgery.
The objective of this study was to determine the impact of opioid use disorder (OUD) on perioperative outcomes after major upper abdominal surgeries. Opioid use disorder (OUD), defined as dependence/abuse, is a national health epidemic. Its impact on outcomes after major abdominal surgery has not been well characterized.
Patients who underwent elective esophagectomy, total/partial gastrectomy, major hepatectomy, and pancreatectomy were identified using the National Inpatient Sample (2003–2015). Propensity score matching by baseline characteristics was performed for patients with and without opioid use disorder (OUD). Outcomes measured were in-hospital complications, mortality, length of stay (LOS), and discharge disposition.
The results of this study are as follows:
Of 376,467 patients, 1096 (0.3%) had opioid use disorder (OUD). Patients with opioid use disorder (OUD) were younger (mean 53 vs 61 years, P < 0.001) and more often male (55.1% vs 53.2%, P < 0.001), black (15.0% vs 7.6%, P < 0.001), Medicaid beneficiaries (22.0% vs 6.4%, P < 0.001), and in the lowest income quartile (32.6% vs 21.3%, P < 0.001). They also had a higher rate of alcohol (17.2% vs 2.8%, P < 0.001) and nonopioid drug (2.2% vs 0.2%, P = 0.023) dependence/abuse. After matching (N = 1077 OUD, N = 2164 no OUD), OUD was associated with a higher complication rate (52.9% vs 37.3%, P < 0.001), including increased pain [odds ratio (OR) 3.5, P < 0.001], delirium (OR 3.0, P = 0.004), and pulmonary complications (OR 2.0, P = 0.006). Additionally, opioid use disorder (OUD) was associated with increased LOS (mean 12.4 vs 10.6 days, P = 0.015) and nonroutine discharge (OR 1.6, P < 0.001). In-hospital mortality did not differ (OR 2.4, P = 0.10).
Thus, the researchers concluded that patients with opioid use disorder (OUD) more frequently experienced complications and increased LOS. Close postoperative monitoring may mitigate adverse outcomes.
Reference:
Opioid Use Disorder is Associated with Complications and Increased Length of Stay After Major Abdominal Surgery by Song, Yun et al. published in the annals of surgery.
https://journals.lww.com/annalsofsurgery/fulltext/2021/12000/opioid_use_disorder_is_associated_with.18.aspx