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Predictors of Discharge Home Without Opioids After Cardiac Surgery: A Multicenter Analysis.
Wagner, Catherine M; Clark, Melissa J; Theurer, Patricia F; Lall, Shelly C; Nemeh, Hassan W; Downey, Richard S; Martin, David E; Dabir, Reza R; Asfaw, Zewditu E; Robinson, Phillip L; Harrington, Steven D; Gandhi, Divyakant B; Waljee, Jennifer F; Englesbe, Michael J; Brummett, Chad M; Prager, Richard L; Likosky, Donald S; Kim, Karen M; Lagisetty, Kiran H; Brescia, Alexander A.
Afiliación
  • Wagner CM; Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
  • Clark MJ; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor, Michigan.
  • Theurer PF; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor, Michigan.
  • Lall SC; Munson Medical Center, Traverse City, Michigan.
  • Nemeh HW; Henry Ford Hospital, Detroit, Michigan.
  • Downey RS; Mercy Health, Muskegon, Michigan.
  • Martin DE; Ascension Borgess Hospital, Kalamazoo, Michigan.
  • Dabir RR; Beaumont Hospital, Dearborn, Michigan.
  • Asfaw ZE; Ascension Providence Hospital, Southfield, Michigan.
  • Robinson PL; Beaumont Hospital, Troy, Michigan.
  • Harrington SD; Henry Ford Macomb Hospital, Clinton Township, Michigan.
  • Gandhi DB; McLaren Greater Lansing, Lansing, Michigan.
  • Waljee JF; Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan; Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan.
  • Englesbe MJ; Department of Surgery, University of Michigan, Ann Arbor, Michigan; Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan.
  • Brummett CM; Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan; Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan.
  • Prager RL; Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor, Michigan.
  • Likosky DS; Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan; Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative, Ann Arbor, Michigan; Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan.
  • Kim KM; Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
  • Lagisetty KH; Department of Surgery, University of Michigan, Ann Arbor, Michigan.
  • Brescia AA; Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan; Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan. Electronic address: abrescia@med.umich.edu.
Ann Thorac Surg ; 114(6): 2195-2201, 2022 12.
Article en En | MEDLINE | ID: mdl-34924190
BACKGROUND: Whether all patients will require an opioid prescription after cardiac surgery is unknown. We performed a multicenter analysis to identify patient predictors of not receiving an opioid prescription at the time of discharge home after cardiac surgery. METHODS: Opioid-naïve patients undergoing coronary artery bypass grafting and/or valve surgery through a sternotomy at 10 centers from January to December 2019 were identified retrospectively from a prospectively maintained data set. Opioid-naïve was defined as not taking opioids at the time of admission. The primary outcome was discharge without an opioid prescription. Mixed-effects logistic regression was performed to identify predictors of discharge without an opioid prescription, and postdischarge opioid prescribing was monitored to assess patient tolerance of discharge without an opioid prescription. RESULTS: Among 1924 eligible opioid-naïve patients, mean age was 64 ± 11 years, and 25% were women. In total, 28% of all patients were discharged without an opioid prescription. On multivariable analysis, older age, longer length of hospital stay, and undergoing surgery during the last 3 months of the study were independent predictors of discharge without an opioid prescription, whereas depression, non-Black and non-White race, and using more opioid pills on the day before discharge were independent predictors of receiving an opioid prescription. Among patients discharged without an opioid prescription, 1.8% (10 of 547) were subsequently prescribed an opioid. CONCLUSIONS: Discharging select patients without an opioid prescription after cardiac surgery appears well tolerated, with a low incidence of postdischarge opioid prescriptions. Increasing the number of patients discharged without an opioid prescription may be an area for quality improvement.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Cardíacos / Analgésicos Opioides Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Thorac Surg Año: 2022 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Cardíacos / Analgésicos Opioides Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Thorac Surg Año: 2022 Tipo del documento: Article Pais de publicación: Países Bajos