Trends and Outcomes of Cardiovascular Surgery in Patients With Opioid Use Disorders

Abstract

IMPORTANCE Persistent opioid use is currently a major health care crisis. There is a lack of knowledge regarding its prevalence and effect among patients undergoing cardiac surgery. OBJECTIVE To characterize the national population of cardiac surgery patients with opioid use disorder (OUD) and compare outcomes with the cardiac surgery population without OUD. DESIGN, SETTING, AND PARTICIPANTS In this retrospective population-based cohort study, more than 5.7 million adult patients who underwent cardiac surgery (ie, coronary artery bypass graft, valve surgery, or aortic surgery) in the United States were included. Pregnant patients were excluded. Propensity matching was performed to compare outcomes between cardiac surgery patients with OUD (n = 11 359) and without OUD (n = 5 707 193).

Persistent Opioid Use Among the Elderly After Lung Resection: A SEER-Medicare Study

“…10 Although persistent opioid use may have a role for some patients to allow function and maintain quality of life, opioid use has been shown to be associated with several deleterious aspects of health. These include overdose, 17 poor compliance with treatment recommendations, 18 operative morbidity and mortality, [1][2][3][4][5][6] and risk of subsequent opioid dependence for family members, 19 among many others.…”

“…However, postoperative morbidity related to opioid therapy can be severe. [1][2][3][4][5][6] Furthermore, chronic use may develop, which is helping to fuel the opioid crisis. 7 From 2001 to 2016, opioid-related deaths in the United States increased 345%.…”

<p>Risk of Postoperative Hyperalgesia in Adult Patients with Preoperative Poor Sleep Quality Undergoing Open-heart Valve Surgery</p>

“…5 However, large analgesic doses could produce significant side effects. [6][7][8] Therefore, there is a need to identify the risk factors for postoperative HA and address them to reduce the use of analgesics and allow rapid recovery from cardiac surgery.…”

Disparities in United States hospitalizations for serious infections in patients with and without opioid use disorder: A nationwide observational study

“…Taken together, these factors may result in longer hospital length of stay (LOS) and increased utilization of PAC facilities among people with OUD-associated infections, with important financial implications for hospitals and payers [14,15]. Prior research and clinical experience suggest that patients with OUD who are hospitalized with endocarditis or undergoing surgery for complications related to endocarditis have longer LOS and more patient-directed discharges (also referred to as "discharges against medical advice") compared to those without OUD [2,[16][17][18][19]. To our knowledge, there is no research to date assessing national differences in healthcare utilization of patients with and without OUD who are hospitalized for serious infections requiring prolonged IV access.…”

“…Prior research and clinical experience suggest that patients with OUD who are hospitalized with endocarditis or undergoing surgery for complications related to endocarditis have longer LOS and more patient-directed discharges (also referred to as “discharges against medical advice”) compared to those without OUD [ 2 , 16 – 19 ]. To our knowledge, there is no research to date assessing national differences in healthcare utilization of patients with and without OUD who are hospitalized for serious infections requiring prolonged IV access.…”