Long-term Outcomes of Persistent Postoperative Opioid Use: A Retrospective Cohort Study.

IF 4.4 2区化学 Q2 MATERIALS SCIENCE, MULTIDISCIPLINARY ACS Applied Polymer Materials Pub Date : 2025-01-01 Epub Date: 2024-12-16 DOI:10.1097/SLA.0000000000005372

Jeffrey J Aalberg, Marc D Kimball, Timothy R McIntire, Geoffrey M McCullen

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Abstract

Objective: To determine the association between PPOU and the long-term risk of OUD and opioid overdose.

Summary background data: PPOU is a commonly used outcome in the surgical literature; its incidence and risk factors have been well described. However, its association to long term outcomes, including OUD and opioid overdose, is unknown.

Methods: A retrospective cohort study utilizing the Veterans Health Administration corporate data warehouse. Patients undergoing any surgery between January 1, 2008 and December 31, 2018 were included and followed until December 31, 2020. Univariate and multivariate survival analysis were used to determine the association between PPOU and OUD and overdose. Sensitivity analyses were conducted to determine the impact of different definitions of persistent opioid use and the effect of preoperative opioid use.

Results: A total of 344,745 patients undergoing surgery were included and followed for a median of 6.18 years (IQR 3.53-9.12). PPOU was associated with an increased hazard of developing both OUD (HR = 1.88, CI: 1.81-1.95, P < 0.001) and overdose (HR = 1.83, CI: 1.72-1.94, P < 0.001). This association remained consistent after adjustment for comorbidities and across all sensitivity analyses.

Conclusions: Surgical patients who develop PPOU are at increased risk of both OUD and overdose as compared to surgical patients who do not develop persistent use.

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术后持续使用阿片类药物的长期后果：回顾性队列研究

目的确定术后持续使用阿片类药物与阿片类药物使用障碍和阿片类药物过量的长期风险之间的关系：术后持续使用阿片类药物是外科文献中常用的结果；其发生率和风险因素已得到充分描述。然而，其与长期结果（包括阿片类药物使用障碍和阿片类药物过量）的关系尚不清楚：方法：利用退伍军人健康管理局企业数据仓库进行回顾性队列研究。研究纳入了在 2008 年 1 月 1 日至 2018 年 12 月 31 日期间接受任何手术的患者，并对其进行随访，直至 2020 年 12 月 31 日。采用单变量和多变量生存分析来确定术后持续使用阿片类药物与阿片类药物使用障碍和用药过量之间的关联。还进行了敏感性分析，以确定持续使用阿片类药物的不同定义的影响以及术前使用阿片类药物的影响：共纳入 304780 名接受手术的患者，随访时间中位数为 5.56 年（IQR 为 3.08-8.65 年）。术后持续使用阿片类药物会增加阿片类药物使用障碍（HR = 1.88，CI：1.80-1.96，p < 0.001）和用药过量（HR = 1.78，CI：1.67-1.90，p < 0.001）的风险。在对合并症进行调整后，以及在所有敏感性分析中，这种关联仍保持一致：结论：与未持续使用阿片类药物的手术患者相比，术后持续使用阿片类药物的手术患者发生阿片类药物使用障碍和用药过量的风险更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Polymer Materials Multiple-

CiteScore

7.20

自引率

6.00%

发文量

810

期刊介绍： ACS Applied Polymer Materials is an interdisciplinary journal publishing original research covering all aspects of engineering, chemistry, physics, and biology relevant to applications of polymers. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates fundamental knowledge in the areas of materials, engineering, physics, bioscience, polymer science and chemistry into important polymer applications. The journal is specifically interested in work that addresses relationships among structure, processing, morphology, chemistry, properties, and function as well as work that provide insights into mechanisms critical to the performance of the polymer for applications.

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