The Effect of Chronic Preoperative Opioid Use on Surgical Site Infections, Length of Stay, and Readmissions

Diseases of the Colon and Rectum
James W OgilvieMartin A Luchtefeld

Abstract

Chronic opioid use in the United States is a well-recognized public health concern with many negative downstream consequences. Few data exist regarding the use of preoperative opioids in relation to outcomes after elective colorectal surgery. The purpose of this study was to determine if chronic opioid use before colorectal surgery is associated with a detriment in postoperative outcomes. This is a retrospective review of administrative data supplemented by individual chart review. This study was conducted in a single-institution, multisurgeon, community colorectal training practice. All patients undergoing elective colorectal surgery over a 3-year time frame (2011-2014) were selected. Opioid use was stratified based on total dose of morphine milligram equivalents (naive, sporadic use (>0-15 mg/day), regular use (>15-45 mg/day), and frequent use (>45 mg/day)). Primary outcomes were surgical site infections, length of hospital stay, and readmissions. Of the 923 patients, 23% (n = 213) were using opioids preoperatively. The preoperative opioid group contained more women (p = 0.047), underwent more open surgery (p = 0.003), had more nonmalignant indications (p = 0.013), and had a higher ASA classification (p = 0.003). Although med...Continue Reading

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