RT Journal Article
SR Electronic
T1 Risk of Persistent Opioid Use following Major Surgery in Matched Samples of Patients with and without Cancer
JF Cancer Epidemiology Biomarkers & Prevention
JO Cancer Epidemiol Biomarkers Prev
FD American Association for Cancer Research
DO 10.1158/1055-9965.EPI-20-0628
A1 Falcone, Mary
A1 Luo, Chongliang
A1 Chen, Yong
A1 Birtwell, David
A1 Cheatle, Martin
A1 Duan, Rui
A1 Gabriel, Peter E.
A1 He, Lifang
A1 Ko, Emily M.
A1 Lenz, Heinz-Josef
A1 Mirkovic, Nebojsa
A1 Mowery, Danielle L.
A1 Ochroch, E. Andrew
A1 Paulson, E. Carter
A1 Schriver, Emily
A1 Schnoll, Robert A.
A1 Bekelman, Justin E.
A1 Lerman, Caryn
YR 2020
UL http://cebp.aacrjournals.org/content/early/2020/09/25/1055-9965.EPI-20-0628.abstract
AB Background: The opioid crisis has reached epidemic proportions, yet risk of persistent opioid use following curative intent surgery for cancer and factors influencing this risk are not well understood.Methods: We used electronic health record data from 3,901 adult patients who received a prescription for an opioid analgesic related to hysterectomy or large bowel surgery from January 1, 2013, through June 30, 2018. Patients with and without a cancer diagnosis were matched on the basis of demographic, clinical, and procedural variables and compared for persistent opioid use.Results: Cancer diagnosis was associated with greater risk for persistent opioid use after hysterectomy [18.9% vs. 9.6%; adjusted OR (aOR), 2.26; 95% confidence interval (CI), 1.38–3.69; P = 0.001], but not after large bowel surgery (28.3% vs. 24.1%; aOR 1.25; 95% CI, 0.97–1.59; P = 0.09). In the cancer hysterectomy cohort, persistent opioid use was associated with cancer stage (increased rates among those with stage III cancer compared with stage I) and use of neoadjuvant or adjuvant chemotherapy; however, these factors were not associated with persistent opioid use in the large bowel cohort.Conclusions: Patients with cancer may have an increased risk of persistent opioid use following hysterectomy.Impact: Risks and benefits of opioid analgesia for surgical pain among patients with cancer undergoing hysterectomy should be carefully considered.