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. 2019 Apr;217(4):605-612.
doi: 10.1016/j.amjsurg.2018.12.068. Epub 2019 Jan 4.

Association between postoperative opioid use and outpatient surgical adverse events

Elise A Dasinger  1 , Westyn Branch-Elliman  2 , Steven D Pizer  3 , Hassen Abdulkerim  4 , Amy K Rosen  5 , Martin P Charns  6 , Mary T Hawn  7 , Kamal M F Itani  8 , Hillary J Mull  5
Affiliations

Association between postoperative opioid use and outpatient surgical adverse events

Elise A Dasinger et al. Am J Surg. 2019 Apr.

Abstract

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.

Keywords: Adverse events; Ambulatory surgery; Opioids; Patient safety; Quality improvement; Veterans.

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Figures

Appendix 2.
Appendix 2.. Number of Days Supplied of Postoperative Opioids within 48 hours of Outpatient Surgery
Note: Represents 628, 36% of 1,730 chart reviewed outpatient surgeries performed in VA surgical facilities between FY12–14.
Figure 1.
Figure 1.
Rate of Postoperative Opioid Use over Time in Chart Review Sample (FY12–14 VA Outpatient Surgeries, n=1,730)
See this image and copyright information in PMC

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