What Drives Opioid Prescriptions After Cardiac Surgery: Practice or Patient?

The Annals of Thoracic Surgery
Kimberly A HolstElizabeth B Habermann

Abstract

The objectives of this study were to describe opioid prescribing after hospitalization for elective cardiac operation, to identify factors associated with increased opioid prescriptions, and to develop procedure-specific opioid prescribing guidelines. We analyzed data from all adults (≥18 years) undergoing elective cardiac operation for acquired heart disease from July 2014 to March 2017 at 3 affiliated hospitals. Opioid prescription data were abstracted and converted to morphine milligram equivalents (MME). Multivariable logistic regression was performed with the outcome of top-quartile prescriptions. There were 4145 study patients after exclusion of preoperative opioid users (10.5%). Mean ± SD patient age was 63.9 ± 13.2 years, and 68.4% (n = 2835) were male. The operation was the first in 87.3% (3617); the most common operative approach was sternotomy in 91.0% (n = 3773), followed by robot-assisted operation in 4.6% (n = 192). The majority of patients, 72.7%, received an opioid prescription at hospital dismissal, with a median opioid prescription of 200 MME (interquartile range 0 to 375 MME; range 0 to 6400 MME). This varied by hospital, with medians of 150, 450, and 600 MME (P < .001). On multivariable analysis, the factor ...Continue Reading

Citations

Sep 6, 2020·Nature Reviews. Cardiology·Elizabeth B Habermann
Aug 28, 2020·Journal of Surgical Education·Jennifer E BakerMichael D Goodman
May 25, 2021·The Journal of Thoracic and Cardiovascular Surgery·J W Awori HayangaRakesh C Arora

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