Chronic postoperative opioid use after open cardiac surgery: A Danish population-based cohort study

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BACKGROUND: Knowledge of chronic opioid use after cardiac surgery is sparse. We therefore aimed to describe the proportion of new chronic postoperative opioid use after open cardiac surgery.

METHODS: We used prospectively registered data from a national prescription registry and a clinical registry of 29,815 first-time cardiac surgeries from three Danish university hospitals. Data collection spanned from 2003 to 2016. The main outcome was chronic postoperative opioid use, defined as at least one opioid dispensing in the fourth postoperative quarter. Data was assessed for patient-level predictors of chronic postoperative opioid use, including preoperative opioid use, opioid use at discharge, comorbidities and procedural related variables.

RESULTS: The overall proportion of postoperative opioid use was 10.6% (95% CI: 10.2-10.9). The proportion of new chronic postoperative opioid use was 5.7 % (95% CI: 5.5-6.0) among preoperative opioid naïve patients. The corresponding proportions among patients, who preoperatively used low or high dose opioid (1-500 mg or >500 mg cumulative morphine equivalent opioid), were 68.3% (95% CI: 66.1-70.4) and 76.3% (95% CI: 74.0-78.5) respectively. Risk factors associated with new chronic postoperative opioid use included: female sex, underweight and obesity, preoperative comorbidities, acute surgery, ICU-time >1 day, and postoperative complications. Strongest predictor of chronic postoperative opioid use was post-discharge use of opioid within one month after surgery (odds ratio 3.3, 95% CI: 2.8-4.0).

CONCLUSION: New chronic postoperative opioid use after open cardiac surgery is common. Focus on post-discharge opioid use may help clinicians to reduce rates of new chronic opioid users.

Original languageEnglish
JournalActa Anaesthesiologica Scandinavica
Pages (from-to)47-57
Number of pages11
Publication statusPublished - Jan 2021

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