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Opioid-related adverse drug events in surgical hospitalizations: impact on costs and length of stay.
Ann Pharmacother. 2007 Mar; 41(3):400-6.AP

Abstract

BACKGROUND

Opioid analgesics remain a mainstay in the treatment of pain associated with surgical procedures. Such use is associated with adverse drug events (ADEs).

OBJECTIVE

To investigate the impact of opioid-related ADEs on total hospital costs and length of stay (LOS) in adult surgical patients.

METHODS

This was a retrospective matched cohort study using data from computerized medical records. ADE cases were prospectively detected using computerized surveillance and verified by pharmacists. Surgical patients treated at LDS Hospital in Salt Lake City from January 1, 1998, to December 31, 2003, were included. The primary outcomes were costs and hospital LOS associated with opioid-related ADEs and the relationship of opioid dose to ADE events.

RESULTS

Patients experiencing opioid-related ADEs had significantly increased median total hospital costs (7.4% increase; 95% CI 3.83 to 10.96; p < 0.001) and increased median LOS (10.3% increase; 95% CI 6.5 to 14.2; p < 0.001) compared with matched non-ADE controls. The increased costs attributable to ADEs, by surgery type, were general surgery ($676.51; 95% CI 351.50 to 1001.50), orthopedics ($861.50; 95% CI 448.20 to 1274.80), and obstetrics/gynecology ($540.90; 95% CI 281.40 to 800.40). Similarly, increased LOS attributable to ADEs, by surgery type, were general surgery (0.64 days; 95% CI 0.40 to 0.88), orthopedics (0.52 days; 95% CI 0.33 to 0.71), and obstetrics/gynecology (0.53 days; 95% CI 0.33 to 0.72). Higher doses of opioids were associated with increased risk of experiencing ADEs (OR 1.3; 95% CI 1.07 to 1.60; p = 0.01).

CONCLUSIONS

Opioid-related ADEs following surgery were associated with significantly increased LOS and hospitalization costs. These ADEs occurred more frequently in patients receiving higher doses of opioids.

Authors+Show Affiliations

Pharmacotherapy Outcomes Research Center, University of Utah Health Sciences Center, Salt Lake City, UT 84108, USA. Gary.Oderda@pharm.utah.edu <Gary.Oderda@pharm.utah.edu>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17341537

Citation

Oderda, Gary M., et al. "Opioid-related Adverse Drug Events in Surgical Hospitalizations: Impact On Costs and Length of Stay." The Annals of Pharmacotherapy, vol. 41, no. 3, 2007, pp. 400-6.
Oderda GM, Said Q, Evans RS, et al. Opioid-related adverse drug events in surgical hospitalizations: impact on costs and length of stay. Ann Pharmacother. 2007;41(3):400-6.
Oderda, G. M., Said, Q., Evans, R. S., Stoddard, G. J., Lloyd, J., Jackson, K., Rublee, D., & Samore, M. H. (2007). Opioid-related adverse drug events in surgical hospitalizations: impact on costs and length of stay. The Annals of Pharmacotherapy, 41(3), 400-6.
Oderda GM, et al. Opioid-related Adverse Drug Events in Surgical Hospitalizations: Impact On Costs and Length of Stay. Ann Pharmacother. 2007;41(3):400-6. PubMed PMID: 17341537.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Opioid-related adverse drug events in surgical hospitalizations: impact on costs and length of stay. AU - Oderda,Gary M, AU - Said,Qayyim, AU - Evans,R Scott, AU - Stoddard,Gregory J, AU - Lloyd,Jim, AU - Jackson,Kenneth, AU - Rublee,Dale, AU - Samore,Matthew H, Y1 - 2007/03/06/ PY - 2007/3/8/pubmed PY - 2007/5/3/medline PY - 2007/3/8/entrez SP - 400 EP - 6 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 41 IS - 3 N2 - BACKGROUND: Opioid analgesics remain a mainstay in the treatment of pain associated with surgical procedures. Such use is associated with adverse drug events (ADEs). OBJECTIVE: To investigate the impact of opioid-related ADEs on total hospital costs and length of stay (LOS) in adult surgical patients. METHODS: This was a retrospective matched cohort study using data from computerized medical records. ADE cases were prospectively detected using computerized surveillance and verified by pharmacists. Surgical patients treated at LDS Hospital in Salt Lake City from January 1, 1998, to December 31, 2003, were included. The primary outcomes were costs and hospital LOS associated with opioid-related ADEs and the relationship of opioid dose to ADE events. RESULTS: Patients experiencing opioid-related ADEs had significantly increased median total hospital costs (7.4% increase; 95% CI 3.83 to 10.96; p < 0.001) and increased median LOS (10.3% increase; 95% CI 6.5 to 14.2; p < 0.001) compared with matched non-ADE controls. The increased costs attributable to ADEs, by surgery type, were general surgery ($676.51; 95% CI 351.50 to 1001.50), orthopedics ($861.50; 95% CI 448.20 to 1274.80), and obstetrics/gynecology ($540.90; 95% CI 281.40 to 800.40). Similarly, increased LOS attributable to ADEs, by surgery type, were general surgery (0.64 days; 95% CI 0.40 to 0.88), orthopedics (0.52 days; 95% CI 0.33 to 0.71), and obstetrics/gynecology (0.53 days; 95% CI 0.33 to 0.72). Higher doses of opioids were associated with increased risk of experiencing ADEs (OR 1.3; 95% CI 1.07 to 1.60; p = 0.01). CONCLUSIONS: Opioid-related ADEs following surgery were associated with significantly increased LOS and hospitalization costs. These ADEs occurred more frequently in patients receiving higher doses of opioids. SN - 1542-6270 UR - https://www.unboundmedicine.com/medline/citation/17341537/Opioid_related_adverse_drug_events_in_surgical_hospitalizations:_impact_on_costs_and_length_of_stay_ L2 - http://journals.sagepub.com/doi/full/10.1345/aph.1H386?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -