Preoperative Opioid Use Disorder Is Associated With Poorer Outcomes After Coronary Bypass and Valve Surgery: A Multistate Analysis, 2007–2014

Boltunova, Alina; Bailey, Caryl; Weinberg, Roniel; Ma, Xiaoyue; Thalappillil, Richard; Tam, Christopher W.; White, Robert S.

doi:10.1053/j.jvca.2020.06.006

Cited by 5 publications

(3 citation statements)

References 39 publications

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“…Despite the heightened awareness and educational focus on OUD prevention, there has been a lack of education and training for surgeons on the perioperative treatment of patients with OUD. Patients with OUD undergoing surgery have increased length of stay, increased pain and a higher complication rate than their counterparts [ 12 – 15 ]. While these studies have shown worse outcomes for OUD patients, standardized guidelines for the surgical community on how to better care for these patients other than preventative strategies are limited.…”

Section: Introductionmentioning

confidence: 99%

Surgeons’ knowledge regarding perioperative pain management in patients with opioid use disorder: a survey among 260 members of the American College of Surgeons

Burgess,

Heneghan,

Barot

et al. 2024

Patient Saf Surg

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Background Patients with opioid use disorder (OUD) are increasing, challenging surgeons to adjust post-operative pain management guidelines. A literature review identified limited information on how to best care for these patients. The purpose of this study was to determine surgical perioperative management of OUD, challenges, and support needed for optimal care. Methods This study utilized an anonymous voluntary survey that was distributed to members of the American College of Surgeons through the association’s electronic weekly newsletter. The survey was advertised weekly for three consecutive weeks. The survey included questions regarding surgeons’ management of perioperative pain in patients with opioid use disorder and perceived barriers in treatment. Results A total of 260 surgeons responded representing all specialties except ophthalmology. General surgery (66.5%) and plastic and reconstructive surgery (7.5%) represented the majority of responders. Ninety-five percent of surgeons reported treating a patient who used opioids in the past month and 86% encountered a patient with OUD. Nearly half (46%) reported being uncomfortable managing postoperative pain in patients with OUD. Most (67%) were not aware of any guidelines or standards pertaining to perioperative management of patients with OUD. While consultation was sought by 86% of surgeons, analyses identified lack of timely response and a lack of care coordination among specialists. Lack of knowledge and fear of harm (contributing further to addiction) were the most common themes. Conclusion Nearly half of surgeons report discomfort caring for patients with OUD with the vast majority involving a consulting service to assist with their care. Most surgeons believe that it would be helpful to have guidelines regarding the care of these patients. This provides an opportunity for increased education and training on the perioperative management of patients with OUD and further collaboration with addiction medicine, psychiatry and pain management colleagues.

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Section: Introductionmentioning

confidence: 99%

Surgeons’ knowledge regarding perioperative pain management in patients with opioid use disorder: a survey among 260 members of the American College of Surgeons

Burgess,

Heneghan,

Barot

et al. 2024

Patient Saf Surg

View full text Add to dashboard Cite

show abstract

“…The complications associated with chronic opioid use and surgical outcomes have been well-documented in most surgical fields, particularly within the field of orthopedic surgery. [4][5][6][7][8][9][10][11] Compared to their non-opioid using counterparts, OUD patients have been reported to have higher rates complications such as thromboembolic and infectious related complications. Vakharia et al, reported that OUD patients undergoing primary total knee arthroplasty resulted in higher rates of coagulationrelated complications, leading to longer hospitalizations and increased morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…The complications associated with chronic opioid use and surgical outcomes have been well-documented in most surgical fields, particularly within the field of orthopedic surgery. 4 - 11 …”

Section: Introductionmentioning

confidence: 99%

Opioid Use Disorder in Patients Undergoing Primary 1- to 2-Level Anterior Cervical Discectomy and Fusion Is Associated With Longer In-Hospital Lengths of Stay and Higher Rates of Readmissions, Complications, and Costs of Care

Kim

Lam

Golub

et al. 2021

Global Spine Journal

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Study Design: Retrospective study. Objective: To determine whether opioid use disorder (OUD) patients undergoing 1- to 2-level anterior cervical discectomy and fusion (1-2ACDF) have higher rates of: 1) in-hospital lengths of stay (LOS); 2) readmissions; 3) complications; and 4) costs. Methods: OUD patients undergoing primary 1-2ACDF were identified within the Medicare database and matched to a control cohort in a 1:5 ratio by age, sex, and medical comorbidities. The query yielded 80,683 patients who underwent 1-2 ACDF with (n = 13,448) and without (n = 67,235) OUD. Outcomes analyzed included in-hospital LOS, 90-day readmission rates, 90-day medical complications, and costs. Multivariate logistic regression analyses were used to calculate odds-ratios (OR) for medical complications and readmissions. Welch’s t-test was used to test for significance for LOS and cost between the cohorts. An alpha value less than 0.002 was considered statistically significant. Results: OUD patients were found to have significantly longer in-hospital LOS compared to their counterparts (3.41 vs. 2.23-days, P < .0001), in addition to higher frequency and odds of requiring readmissions (21.62 vs. 11.57%; OR: 1.38, P < .0001). Study group patients were found to have higher frequency and odds of developing medical complications (0.88 vs. 0.19%, OR: 2.80, P < .0001) and incurred higher episode of care costs ($20,399.62 vs. $16,812.14, P < .0001). Conclusion: The study can help to push orthopaedic surgeons in better managing OUD patients pre-operatively in terms of safe discontinuation and education of opioid drugs and their effects on complications, leading to more satisfactory outcomes.

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Outcomes of Infrainguinal Bypass in Patients with Cannabis vs Opioid Use Disorder

Narayanan¹,

Alnahhal²,

Lingutla³

et al. 2022

Annals of Vascular Surgery

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Preoperative Opioid Use Disorder Is Associated With Poorer Outcomes After Coronary Bypass and Valve Surgery: A Multistate Analysis, 2007–2014

Cited by 5 publications

References 39 publications

Surgeons’ knowledge regarding perioperative pain management in patients with opioid use disorder: a survey among 260 members of the American College of Surgeons

Surgeons’ knowledge regarding perioperative pain management in patients with opioid use disorder: a survey among 260 members of the American College of Surgeons

Opioid Use Disorder in Patients Undergoing Primary 1- to 2-Level Anterior Cervical Discectomy and Fusion Is Associated With Longer In-Hospital Lengths of Stay and Higher Rates of Readmissions, Complications, and Costs of Care

Outcomes of Infrainguinal Bypass in Patients with Cannabis vs Opioid Use Disorder

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