(HealthDay)—Persistent opioid use is a standard concern after cardiac surgery, in keeping with a research revealed on-line June 17 in JAMA Cardiology.
Chase R. Brown, M.D., from the University of Pennsylvania in Philadelphia, and colleagues used knowledge from a nationwide administrative claims database (2004 by 2016) to determine 35,817 patients who underwent coronary artery bypass grafting (CABG; 25,673 patients) or coronary heart valve (10,144 patients) procedures. All included patients have been opioid-naive inside 180 days earlier than the process and stuffed an opioid prescription inside 14 days after surgery. New persistent opioid use inside 90 to 180 days after surgery was assessed.
The researchers discovered that persistent opioid use occurred in 3,430 patients (9.6 percent) following cardiac surgery, together with 2,609 patients present process CABG (10.2 percent) and 821 patients present process valve surgery (8.1 percent). There was a decrease chance for growing persistent opioid use amongst coronary heart valve surgery recipients (odds ratio [OR], 0.78; 95 percent confidence interval [CI], 0.70 to 0.86), however greater chance for ladies (OR, 1.15; 95 percent CI, 1.03 to 1.26), youthful age (OR, 1.02; 95 percent CI, 1.01 to 1.02), congestive heart failure (OR, 1.17; 95 percent CI, 1.06 to 1.30), chronic lung disease (OR, 1.32; 95 percent CI, 1.19 to 1.45), diabetes (OR, 1.27; 95 percent CI, 1.15 to 1.40), kidney failure (OR, 1.17; 95 percent CI, 1.00 to 1.37), chronic pain (OR, 2.71; 95 percent CI, 2.10 to three.56), alcoholism (OR, 1.56; 95 percent CI, 1.23 to 2.00), preoperative use of benzodiazepines (OR, 1.71; 95 percent CI, 1.52 to 1.91), and preoperative use of muscle relaxants (OR, 1.74; 95 percent CI, 1.51 to 2.02). There was additionally a considerably elevated danger of new persistent opioid use when patients have been prescribed >300 milligrams of oral morphine equivalents at discharge versus prescriptions for decrease dosages of opioids.
“Centers must adopt protocols to increase patient education and limit opioid prescriptions after discharge,” the authors write.
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Persistent opioid use seen in just under 10 percent of patients after cardiac surgery (2020, August 11)
retrieved 11 August 2020
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