identifying patients at risk for postsurgical opioid-related ......of orthopedic and...

Abstract

Identifying Patients at Risk for Postsurgical Opioid-Related Adverse Events35Kathy Nipper-Johnson, BSN, RN, CCM1; Harold S. Minkowitz, MD1; Richard Scranton, MD, MPH2; Aditya Raju, MS, BPharm3; Akash Dandappanavar, PharmD, MPH, MA3; Laura Menditto, MPH, MBA4

1Memorial Hermann Memorial City Medical Center, Houston, TX; 2Pacira Pharmaceuticals, Inc., Parsippany, NJ; 3Xcenda®AmerisourceBergen Consulting Services, Palm Harbor, FL; 4Laura A. Menditto, LLC, Newtown, PA

Purpose: Identify opioid-related adverse event (ORADE) risk factors, derive a risk score to identify high-risk patients, and evaluate potential benefits of targetinghigh-risk patients for strategies aimed at reducing ORADEs.Methodology: Administrative claims data were analyzed to identify adults who received opioids following gastro-intestinal or orthopedic surgeries. Logisticregression was used to stratify patients according to risk. Generalized linear and binomial regression models were used to compare cost and length of stay (LOS)according to risk. Results: Overall, ORADEs occurred in 551 (11.3%) of the 4,888 patients who received postsurgical opioids and were more frequent in the high-risk group (22%)than the low-risk group (6.9%). Significant risk factors included age, gender, pre-surgical opioid use and several comorbidities such as diabetes and benignprostatic hypertrophy. Higher risk patients had a longer LOS (mean—7.2 vs. 4.1 days, P