• Johannes Dreiling, Norman Rose, Christin Arnold, Philipp Baumbach, Carolin Fleischmann-Struzek, Christine Kubulus, Marcus Komann, Ursula Marschall, Heike Lydia Rittner, Thomas Volk, Winfried Meissner, and Daniel Schwarzkopf.
• Dtsch Arztebl Int. 2024 Nov 15 (Forthcoming).

BackgroundThe risk of persistent postoperative opioid use (PPOU) and its association with the type of surgery are still unclear in Germany.MethodsWe conducted a nationwide retrospective cohort study on the basis of claims data from BARMER, a statutory health insurance carrier in Germany. Opioid-naive adults who did not have cancer and who underwent inpatient surgery in 2018 were included in the study. The operations were divided into 103 categories. PPOU was defined as the prescribing of opioids between postoperative days 1 and 90 and also between postoperative days 91 and 180 after hospital discharge. Patient-associated risk factors in the 12 months before surgery were investigated.Results203 327 patients were included. 1.4% had PPOU (95% confidence interval [1.4; 1.5]). There were major differences between operation groups: major amputations and orthopedic procedures carried the greatest risk for the development of PPOU. The type of surgery had a larger effect on the risk of PPOU than pre-existing risk factors (explained variance 22.3% vs. 14.3%). Among such factors, alcohol abuse and pre-existing treatment with antidepressant drugs were associated with the highest risk for PPOU (odds ratios [OR] 1.515 [1.277; 1.797] and 2.131 [1.943; 2.336]).ConclusionThe incidence of PPOU in Germany is low (1.4%). The type of surgery plays an important role in its development.

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