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

• Published in: The Annals of Thoracic Surgery
• Main Authors: Ingason, Arnar B, Geirsson, Arnar, Gudbjartsson, Tomas, Muehlschlegel, Jochen D, Sigurdsson, Martin I
• Other Authors: 1Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2Division of Cardiac Surgery, Yale School of Medicine, New Haven, Connecticut. 3Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland. 4Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts. 5Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Department of Anesthesiology and Critical Care Medicine, Landspitali University Hospital, Reykjavik, Iceland. Electronic address: [e-mail].
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier 2022
• Subjects: Verkjalyf; Ópíóðar; Hjartaaðgerðir; Analgesics; Opioid; Pain; Postoperative; Cardiac Surgical Procedures; Sternotomy; Iceland
• Online Access: http://hdl.handle.net/2336/622080; https://doi.org/10.1016/j.athoracsur.2021.04.030

To access publisher's full text version of this article click on the hyperlink below 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. University of Iceland Science Fund Landspitali University Science Fund