• Annals of surgery · Dec 2022

    The Association of Postoperative Opioid Prescriptions with Patient Outcomes.

    • Ryan Howard, Craig S Brown, Yen-Ling Lai, Vidhya Gunaseelan, Kao-Ping Chua, Chad Brummett, Michael Englesbe, Jennifer Waljee, and Mark C Bicket.
    • Department of Surgery, Michigan Medicine, Ann Arbor, Michigan.
    • Ann. Surg. 2022 Dec 1; 276 (6): e1076e1082e1076-e1082.

    ObjectiveTo compare outcomes after surgery between patients who were not prescribed opioids and patients who were prescribed opioids.Summary Of Background DataPostoperative opioid prescriptions carry significant risks. Understanding outcomes among patients who receive no opioids after surgery may inform efforts to reduce these risks.MethodsWe performed a retrospective study of adult patients who underwent surgery between January 1, 2019 and October 31, 2019. The primary outcome was the composite incidence of an emergency department visit, readmission, or reoperation within 30 days of surgery. Secondary outcomes were postoperative pain, satisfaction, quality of life, and regret collected via postoperative survey. A multilevel, mixed-effects logistic regression was performed to evaluate differences between groups.ResultsIn a cohort of 22,345 patients, mean age (standard deviation) was 52.1 (16.5) years and 13,269 (59.4%) patients were female. About 3175 (14.2%) patients were not prescribed opioids, of whom 422 (13.3%) met the composite adverse event endpoint compared to 2255 (11.8%) of patients not prescribed opioids ( P = 0.015). Patients not prescribed opioids had a similar probability of adverse events {11.7% [95% confidence interval (CI) 10.2%-13.2%] vs 11.9% (95% CI 10.6%-13.3%]}. Among 12,872 survey respondents, patients who were not prescribed an opioid had a similar rate of high satisfaction [81.7% (95% CI 77.3%-86.1%) vs 81.7% (95% CI 77.7%- 85.7%)] and no regret [(93.0% (95% CI 90.8%-95.2%) vs 92.6% (95% CI 90.4%-94.7%)].ConclusionsPatients who were not prescribed opioids after surgery had similar clinical and patient-reported outcomes as patients who were prescribed opioids. This suggests that minimizing opioids as part of routine postoperative care is unlikely to adversely affect patients.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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