Prospective Cohort Evaluation of Opioid Use and Pain Following Cardiac Surgery
Edward Percy1, Sameer Hirji1, Nicholas Leung1, Morgan Harloff1, Olena Cherkasky1, Farhang Yazdchi1, Richard Cook2, Marc Pelletier3, Tsuyoshi Kaneko1
1Division of Cardiac Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 2Division of Cardiovascular Surgery, University of British Columbia, BC, Canada 3Division of Cardiac Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH
Background: New persistent opioid occurs in 13% of patients following cardiac surgery, however, there is little evidence to guide prescription at discharge. We aimed to evaluate patterns and predictors of opioid consumption following cardiac surgery to guide prescribing practices.
Methods: All consecutive patients undergoing sternotomy-based operations were considered. Patients who used opioids within 3 months of surgery were excluded. A patient-reported diary was used to prospectively track pain and opioid use for 10-days following discharge. Total opioid consumption in morphine milligram equivalents (MME) was confirmed with a researcher-directed pill count.
Results: A total of 104 patients were included, with a mean age of 66 years. Of those discharged with an opioid, 22 (34.9%) used none and 12 (19.0%) used less than half of their prescription. Pain and opioid consumption decreased significantly throughout the discharge period (Figure). In those who used opioids, median total consumption was 64 MME [IQR 38-128]. Patients who used opioids were younger (60.9 vs. 70.0 years, p3 at discharge was independently predictive of opioid use (OR 2.9, 95% CI 1.8-4.8; p
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