The Incidence of New Persistent Opioid Use Following Cardiac Surgery via Sternotomy

Arnar Bragi Ingason, Arnar Geirsson, Tómas Guðbjartsson, Jochen D. Muehlschlegel, Martin Ingi Sigurðsson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In recent years, increased attention has turned toward the risk of chronic opioid use after surgery. In this nationwide cohort study, we examined the rate of new persistent opioid use after cardiac surgery by sternotomy. Methods: All opioid-naive patients undergoing heart surgery by sternotomy from 2005 to 2018 in Iceland were included in the study. Naivety was defined as not filling an opioid prescription within 6 months before surgery. Persistent opioid use was defined as filling at least 1 opioid prescription during the first 90 days after surgery and another 90 to 180 days after the operation. In addition to estimating the incidence of new persistent opioid use, differences in patient characteristics, survival, and readmission rates were compared between the group with and without new persistent opioid use. Results: Of 1227 patients who underwent cardiac surgery by sternotomy during the study period, 925 were included in the study. Of those, 4.6% developed new persistent opioid use. When only patients who filled an opioid prescription after surgery were included, 10.1% developed new persistent opioid use. Chronic obstructive pulmonary disease, preoperative use of nonsteroidal anti-inflammatory drugs, gabapentinoids, and nitrates were associated with increased risk for new persistent opioid use. Patients with new persistent opioid use did not have higher rates of readmission nor all-cause mortality. Conclusions: The rate of new persistent opioid use after cardiac surgery was 4.6%. Future steps should identify strategies to minimize the development of new persistent opioid use.

Original languageEnglish
Pages (from-to)33-40
Number of pages8
JournalAnnals of Thoracic Surgery
Volume113
Issue number1
DOIs
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
This paper was funded by the University of Iceland Science Fund and Landspitali University Science Fund.

Publisher Copyright:
© 2022 The Society of Thoracic Surgeons

Other keywords

  • Åged
  • Analgesics, Opioid
  • Cardiac surgical procedures
  • middle aged
  • Pain, postoperative
  • Sternotomy

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