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Opioid-related respiratory and gastrointestinal adverse events in patients with acute postoperative pain: prevalence, predictors, and burden.
Oderda, Gary M; Senagore, Anthony J; Morland, Kellie; Iqbal, Sheikh Usman; Kugel, Marla; Liu, Sizhu; Habib, Ashraf S.
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  • Oderda GM; Gary M. Oderda, Pharm D, MPH, are with the College of Pharmacy, University of Utah, Salt Lake City, Utah, USA; Anthony J. Senagore, MD, are with the Homer Stryker School of Medicine, Borgess Medical Center/Western Michigan University, Kalamazoo, Michigan, USA; Kellie Morland, Marla Kugel, MS, MPH an
  • Senagore AJ; Gary M. Oderda, Pharm D, MPH, are with the College of Pharmacy, University of Utah, Salt Lake City, Utah, USA; Anthony J. Senagore, MD, are with the Homer Stryker School of Medicine, Borgess Medical Center/Western Michigan University, Kalamazoo, Michigan, USA; Kellie Morland, Marla Kugel, MS, MPH an
  • Morland K; Gary M. Oderda, Pharm D, MPH, are with the College of Pharmacy, University of Utah, Salt Lake City, Utah, USA; Anthony J. Senagore, MD, are with the Homer Stryker School of Medicine, Borgess Medical Center/Western Michigan University, Kalamazoo, Michigan, USA; Kellie Morland, Marla Kugel, MS, MPH an
  • Iqbal SU; Gary M. Oderda, Pharm D, MPH, are with the College of Pharmacy, University of Utah, Salt Lake City, Utah, USA; Anthony J. Senagore, MD, are with the Homer Stryker School of Medicine, Borgess Medical Center/Western Michigan University, Kalamazoo, Michigan, USA; Kellie Morland, Marla Kugel, MS, MPH an
  • Kugel M; Gary M. Oderda, Pharm D, MPH, are with the College of Pharmacy, University of Utah, Salt Lake City, Utah, USA; Anthony J. Senagore, MD, are with the Homer Stryker School of Medicine, Borgess Medical Center/Western Michigan University, Kalamazoo, Michigan, USA; Kellie Morland, Marla Kugel, MS, MPH an
  • Liu S; Gary M. Oderda, Pharm D, MPH, are with the College of Pharmacy, University of Utah, Salt Lake City, Utah, USA; Anthony J. Senagore, MD, are with the Homer Stryker School of Medicine, Borgess Medical Center/Western Michigan University, Kalamazoo, Michigan, USA; Kellie Morland, Marla Kugel, MS, MPH an
  • Habib AS; Gary M. Oderda, Pharm D, MPH, are with the College of Pharmacy, University of Utah, Salt Lake City, Utah, USA; Anthony J. Senagore, MD, are with the Homer Stryker School of Medicine, Borgess Medical Center/Western Michigan University, Kalamazoo, Michigan, USA; Kellie Morland, Marla Kugel, MS, MPH an
J Pain Palliat Care Pharmacother ; 33(3-4): 82-97, 2019.
Article en En | MEDLINE | ID: mdl-31609155
Opioid-induced respiratory depression (OIRD) and postoperative nausea and vomiting (PONV) are challenging, resource-intensive, and costly opioid-related adverse events (ORAEs). Utilizing the Premier Healthcare Database, we identified patients > 18 years old, who underwent at least one surgical procedure of interest (i.e., cardiothoracic/vascular, general/colorectal, obstetric/gynecologic, orthopedic, or urologic), and received at least one dose of intravenous morphine, hydromorphone, or fentanyl for acute postoperative pain. The incidence of OIRD and PONV using ICD-9 codes, factors influencing these AEs, length of stay (LOS) and related costs were analyzed. Among 592,127 inpatient stays, rates of respiratory depression ranged from 3% (obstetric/gynecologic) to 17% (cardiothoracic/vascular) and nausea/vomiting from 44% (obstetric/gynecologic) to 72% (general/colorectal). Increased odds of OIRD were associated with older age (cardiothoracic/vascular, general/colorectal, obstetric/gynecologic); obesity, respiratory conditions, and sleep apnea (all surgery groups); opioid dose (cardiothoracic/vascular, general/colorectal, orthopedic); and sedative use after day 1. Increased odds of PONV were associated with younger age, female sex, and major disease severity. When respiratory depression or nausea/vomiting was present versus absent, LOS was significantly longer, and hospital costs were higher. In this analysis, OIRD and PONV were more prevalent than previously reported, were associated with identifiable risk factors, and had substantial effects on resource utilization and costs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Insuficiencia Respiratoria / Náusea y Vómito Posoperatorios / Dolor Agudo / Analgésicos Opioides Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Pain Palliat Care Pharmacother Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2019 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Dolor Postoperatorio / Insuficiencia Respiratoria / Náusea y Vómito Posoperatorios / Dolor Agudo / Analgésicos Opioides Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Pain Palliat Care Pharmacother Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2019 Tipo del documento: Article Pais de publicación: Reino Unido