Association between postoperative opioid use and outpatient surgical adverse events - 14/03/19
, Westyn Branch-Elliman b, c, d, Steven D. Pizer e, f, Hassen Abdulkerim b, Amy K. Rosen b, g, Martin P. Charns b, f, Mary T. Hawn h, i, Kamal M.F. Itani d, g, j, Hillary J. Mull b, gAbstract |
Background |
Opioid-related adverse drug events are common following inpatient surgical procedures. Little is known about opioid prescribing after outpatient surgical procedures and if opioid use is associated with short term risks of outpatient surgical adverse events (AEs).
Methods |
VA Corporate Data Warehouse was used to identify opioid use within 48 h for FY2012-14 chart-reviewed cases from a larger VA study of AEs in outpatient surgeries. We estimated a multilevel logistic regression model to determine the effect of opioid exposure on risk of AEs between 2 and 30 days postoperatively.
Results |
Of the 1730 outpatient surgical cases, 628 (36%) had postoperative opioid use and 12% had an AE. Opioid use following outpatient surgery was not significantly associated with higher surgical AE rates after controlling for relevant covariates (OR = 1.1 95% CI 0.79–1.54). Only procedure RVUs were associated with higher odds of postoperative AEs.
Conclusions |
Postoperative opioid use following outpatient surgery is not a significant driver of postoperative AEs.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | Postoperative opioid use was not associated with higher surgical AE rates. |
• | The only factor associated with an increased risk of AEs was higher procedure RVUs. |
• | Procedure complexity may pose a greater risk to surgical AEs than postoperative opioids. |
Riassunto |
We explored the association between opioid use following outpatient surgery and the risk of surgical adverse events. Opioid use was not associated with higher surgical adverse event rates; therefore, improvement efforts should look beyond postoperative opioid prescribing as a possible risk factor for adverse events in outpatient surgical care.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Ambulatory surgery, Opioids, Patient safety, Adverse events, Quality improvement, Veterans
Mappa
Vol 217 - N° 4
P. 605-612 - aprile 2019 Ritorno al numero
Articolo precedente
- Optimizing the integration of advanced practitioners in a department of surgery: An operational improvement model
- Laura J. Torbeck, Melissa Hockaday, Cecelia Smith, Gary Dunnington
- Temporal trends in opioid prescribing for common general surgical procedures in the opioid crisis era
- Tamar B. Nobel, Shruti Zaveri, Prerna Khetan, Celia M. Divino
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