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Preoperative opioid use leads to perioperative consequences in foot and ankle surgery
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CHICAGO — Preoperative opioid exposure was linked with significant perioperative consequences and postoperative complications in patients who underwent foot and ankle surgery, according to a presenter at the American Orthopaedic Foot & Ankle Society Annual Meeting.
“We were able to identify preoperative opioid exposure has significant perioperative consequences, which include remaining on narcotics all the way out to 1 year postoperatively, increased risk of readmission at 30 and 90 days postoperatively and is often associated with postoperative complications,” Ryan M. Ridenour, MD, said during his presentation.
Ridenour and colleagues used the MarketScan commercial claims and encounters database to identify 112,893 patients who underwent foot and ankle surgery based on CPT codes. Investigators documented comorbidities including Diagnostic and Statistical Manual of Mental Disorders-V mental health disorders, chronic pain, chronic regional pain syndrome, obesity, tobacco use, medications and diabetes. They identified patients who used opioids 1 month to 3 months before surgery. Odds ratio, 995% confidence intervals and regression analysis were used to determine factors that correlated with prolonged postoperative use at three different time intervals.
Investigators found 11,523 patients used opioids 1 month to 3 months preoperatively. Opioids were used by 5,732 patients, 4,364 patients, 3,475 patients and 2,579 patients at 6 weeks, 3 months, 6 months and 1 year postoperatively, respectively.
Preoperative opioid use correlated with increased postoperative use, increased risk of readmission, deep vein thrombosis, pulmonary embolism, irrigation and debridement of the surgical site, myocardial infarction, urinary tract infection and postoperative bleeding. Factors correlated with the risk of postoperative opioid use included tobacco use, chronic pain, Diagnostic and Statistical Manual of Mental Disorders-V diagnosis and nonopioid analgesia. – by Monica Jaramillo
Reference:
Ridenour RM, et al. Opioid use, perioperative risk and associated postoperative complications in foot and ankle surgery. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; Sept. 12-15, 2019; Chicago.
Disclosure: Ridenour reports no relevant financial disclosures.