Rates and Risk Factors for Opioid Dependence and Overdose After Urologic Surgery Journal Article

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Authors: Shah, A. S.; Blackwell, R. H.; Kuo, P. C.; Gupta, G. N.
Article Title: Rates and Risk Factors for Opioid Dependence and Overdose After Urologic Surgery
Abstract: INTRODUCTION: Effective pain management is a critical component of the perioperative process, with opioids representing a mainstay of therapy. The opioid epidemic is a growing concern in the United States. The goal of this study was to quantify the risk of opioid dependence or overdose (ODO) among patients undergoing urologic surgery and to identify risk factors of ODO. METHODS: A retrospective review of urologic surgery from 2007-2011. Data sources included the Healthcare Cost and Utilization Project Inpatient, Ambulatory Surgery, and Emergency Department datasets. Outcomes of postoperative opioid dependence and opioid overdose were identified by previously validated ICD-9 codes. Multivariable logistic regression was performed, adjusted for surgical procedure, to identify predictors of ODO following urologic surgery. RESULTS: Overall, 675,527 patients underwent urologic surgery, with 0.09% of patients diagnosed with ODO. Patients who developed ODO were younger (median 51 vs 62 years), carried non-private insurance (69.6% vs 66%), underwent an inpatient procedure (81.0% vs 42.4%), had a longer length of stay (median 3 vs 0 days), and carried a history of depression (14.4% vs 3.4%) or COPD (20.3% vs 8.9%), all plt;0.001. On adjusted multivariable analysis these factors remained independent risk factors for ODO. CONCLUSIONS: Postoperative ODO affects 1 in 1,111 urologic surgery patients. Risk factors for ODO included younger age, inpatient surgery and increasing hospitalization length, baseline depression, tobacco use, COPD, as well as insurance provider (Medicaid, Medicare (under 65 years old), or non-insured status).
Journal Title: The Journal of urology
ISSN: 1527-3792; 0022-5347
Publisher: Unknown  
Journal Place: United States
Date Published: 2017
Language: eng
DOI/URL:

S0022-5347(17)67187-8
Notes: LR: 20170516; CI: Copyright (c) 2017; JID: 0376374; OTO: NOTNLM; 2017/05/04 [accepted]; aheadofprint