March 9 (UPI) — Researchers at the University of Michigan found in a recent study that opioid prescription drugs taken before surgery may result in longer hospital stays and increased risk of inpatient follow-up care.
The study revealed patients who take opioid painkillers in the months leading up to elective abdominal surgery, such as bariatric surgery or hysterectomy, have an increased risk for longer hospital stays and needing follow-up care in a hospital or rehabilitation facility compared to patients who do not take opioids prior to surgery.
The additional care also doubled or tripled the amount of post-surgery care costs, with higher opioid doses resulting in higher costs.
“We often pause when we are considering elective surgery with a patient, based on known risk factors such as smoking, anticoagulant use, and overall medical conditions,” Dr. Jennifer Waljee, a plastic surgeon at Michigan Medicine, said in a press release. “These findings suggest that perhaps preoperative opioid use warrants the same awareness.”
For the study, researchers followed 200,000 middle-class people who had hysterectomies, bariatric surgery, hernia repair and reflux surgery and spent at least one night in the hospital over a 42-month period.
Approximately 9 percent of patients reported filling at least two opioid prescriptions within 90 days before surgery, with one patient filling an opioid prescription within a month of surgery.
The researchers found patients who had been prescribed opioids before surgery spent an extra half a day on average in the hospital after surgery than patients who did not take opioids. The patients taking opioid prescription medication before surgery also were more likely to end up back in the hospital or to go to a rehabilitation facility within 30 days of surgery, except patients taking the lowest possible doses.
The researchers also report healthcare costs were three times higher in the first 90 days post-surgery for patients taking opioids than those who did not.
The cost discrepancy narrowed after a year but was still twice as high for patients who took opioid prescriptions prior to surgery than those who did not.
“The bottom line is that preoperative opioid use is an important and potentially modifiable risk factor prior to surgery, and should be on surgeons’ radar as well as the minds of primary care providers,” Waljee said. “Coordinating care throughout the surgical period could improve clinical outcomes and the patient experience.”
The study was published in Annals of Surgery.
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