Predictors of Opioid Prescription Refill After Lung Cancer Resection

Abstract

Introduction

Thoracic surgery patients are among the least likely to be on opioids before surgery but have the highest rate of new persistent opioid use after surgery compared to other surgical cohorts. Nearly 27% of opioid-naïve lung cancer resection patients become new persistent opioid users. We aimed to identify risk factors for postdischarge opioid prescription refill within 90 ds of surgery for lung cancer resection patients.

Methods

Retrospective cohort study of all opioid-naïve patients undergoing lung cancer resection from July 2018 to May 2021 at an academic medical center. Multivariable logistic regression was used to identify risk factors for opioid prescription refill between discharge and 90 ds after surgery.

Results

The cohort included 152 patients, 100 (65.8%) women with a median (IQR) age of 71 (65 – 75) and 115 (75.7%) of whom lived with family or friends (versus. alone). Twenty-nine (19.1%) patients had an opioid prescription refill after discharge. Risk factors for opioid prescription refill included living with others (adjusted odds ratio [aOR] 5.31, 95% CI 1.06–26.64), thoracotomy (4.31, 1.37–13.52), chest tube duration (days) (1.14, 1.02–1.27), age (1.08, 1.01–1.16), and morphine milligram equivalents (MME) on the day before discharge (1.07, 1.02–1.11).

Conclusions

We identified risk factors for opioid prescription refill after lung cancer resection: living with family or friend (versus alone), thoracotomy, chest tube duration, increasing age, and MME on the day before discharge. Some of these, namely thoracotomy, chest tube duration, and MME on the day before discharge, may aid patient-centered opioid prescribing.