For patients undergoing invasive procedures, opioid-related adverse drug events (ORADEs) are common and are associated with worse clinical and cost outcomes, according to a study published in JAMA Surgery.
The study included patients who underwent surgical and endoscopic procedures and who were given opioid medications from January 1, 2013, through September 30, 2015, at 21 acute care hospitals that are part of a large, integrated health care delivery system (n=135,379). The researchers identified ORADEs using the International Classification of Diseases, Ninth Revision diagnosis codes for known adverse effects of opioid or opioid antagonist use.
In total, 14,386 patients (10.6%) experienced at least 1 ORADE. Participants who experienced ORADEs were more likely to be older, white, men, and have more comorbidities. Participants who experienced ORADEs received a higher total dose of opioid medication compared with participants who did not experience ORADEs (46.8 vs 30.0 median morphine milligram equivalent dose, respectively; P <.001). Participants with vs without ORADEs were also given opioid medications for a longer duration (median, 3.0 vs 2.0 days, respectively; P <.001).
ORADEs were found to be associated with a number of negative outcomes, including increased inpatient mortality (odds ratio [OR], 28.8; 95% CI, 24.0-34.5), greater likelihood of discharge to another care facility (OR, 2.9; 95% CI, 2.7-3.0), prolonged length of stay (OR, 3.1; 95% CI, 2.8-3.4), high cost of hospitalization (OR, 2.7; 95% CI, 2.4-3.0), and higher rate of 30-day readmission (OR, 1.3; 95% CI, 1.2-1.4).
“Hospital-acquired harm from ORADEs in the surgical patient population is an important opportunity for health systems to improve patient safety and reduce cost,” concluded the study authors.
Shafi S, Collinsworth AW, Copeland LA, et al. Association of opioid-related adverse drug events with clinical and cost outcomes among surgical patients in a large integrated health care delivery system. [published online May 23, 2018]. JAMA Surg. doi:10.1001/jamasurg.2018.1039