Methods: A retrospective cohort analysis was performed of patients undergoing major operating room procedures in 2013 and 2014 using the National Readmission Database. Patients with opioid abuse or dependence were identified using International Classification of Diseases codes. The primary outcome was 30-day hospital readmission rate. Secondary outcomes included hospital length of stay and estimated hospital costs.
Results: Among the 16,016,842 patients who had a major operating room procedure whose death status was known, 94,903 (0.6%) had diagnoses of opioid abuse or dependence. After adjustment for potential confounders, patients with opioid abuse or dependence had higher 30-day readmission rates (11.1% vs. 9.1%; odds ratio 1.26; 95% CI, 1.22 to 1.30), longer mean hospital length of stay at initial admission (6 vs. 4 days; P < 0.0001), and higher estimated hospital costs during initial admission ($18,528 vs. $16,617; P < 0.0001). Length of stay was also higher at readmission (6 days vs. 5 days; P < 0.0001). Readmissions for infection (27.0% vs. 18.9%; P < 0.0001), opioid overdose (1.0% vs. 0.1%; P< 0.0001), and acute pain (1.0% vs. 0.5%; P < 0.0001) were more common in patients with opioid abuse or dependence.
Conclusions: Opioid abuse and dependence are associated with increased readmission rates and healthcare utilization after surgery.
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Limited studies have found greater readmission rates in opioid-tolerant compared to nontolerant patients
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However, these were not nationally representative studies and did not specifically target patients with opioid abuse or dependence
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The National Readmission Database for 2013 and 2014 was analyzed to compare readmission rates in patients with or without opioid abuse or dependence undergoing major operating room diagnostic or therapeutic procedures
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Patients with opioid abuse or dependence had higher 30-day readmission rates (11.1% vs. 9.1%)
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Readmissions for infection, opioid overdose, and acute pain were more common in patients with opioid abuse or dependence
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