Differing practice patterns contribute to significant variation in rates of perioperative transfusion within a single center. Strategies aimed at reducing overall transfusion rates must take into account such variability in practice patterns and account for nonclinical factors as well as known clinical predictors of blood transfusions.

Background Opioid dependence has become a major health care issue. Pain management of invasive surgical procedures with opioids may potentially contribute to this epidemic. We sought to determine the association of opioid‐prescribing patterns with chronic opioid use. Methods We retrospectively reviewed all patients undergoing isolated coronary artery bypass graft (CABG) procedures during 2016 at a single institution. Prescribing patterns and medication usage were compared between opioid‐naïve and opioid‐exposed patients (patients with reported opioid use within 30 days prior to surgery). Chronic opioid dependence was defined as opioid usage beyond 90 days after discharge. Results We included 284 opioid‐naïve and 46 opioid‐exposed patients. Although overall prescribing patterns were similar between groups, a higher proportion of opioid‐exposed patients were prescribed a total dose >150 mg of oxycodone per discharge prescription (15.2% vs 4.9%; P = 0.024), and had a higher proportion of refills within 30 days (28.3% vs 10.9%; relative risk [RR] 3.2 [95% confidence interval (CI): 1.5‐6.8]; all P < 0.05). The incidence of chronic opioid dependence was higher among opioid‐exposed patients compared to opioid‐naïve patients (21.7% vs 3.2%; RR 8.5 [95%CI: 3.2‐22.3]; P = 0.001). Conclusions Ongoing opioid use 3 months after CABG is present in 21.7% of opioid‐exposed patients and 3.2% of opioid‐naïve patients. These preliminary findings highlight the burden of prescribing patterns on the overall opioid epidemic and the need to develop alternative pain management strategies.

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