Potential opioid-related adverse events following spine surgery in elderly patients

Jones, Mark R.; Brovman, Ethan Y.; Novitch, Matthew B.; Rao, Nikhilesh; Urman, Richard D.

doi:10.1016/j.clineuro.2019.105550

Cited by 17 publications

(27 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Older age and male gender were associated with a higher risk of experiencing all general ORADEs. Advanced age was a significant risk factor in all nine studies, 11‐13,20‐24,27 with most studies 11,12,20‐24 reporting that age of ≥65 years increased the odds of all general ORADEs by 1.1–2.3 times compared to those aged <65 years. Eight studies 11‐13,20‐24 identified male gender as a risk factor which would increase the odds of general ORADEs by 1.1–2.0 times compared to females.…”

Section: Resultsmentioning

confidence: 94%

“…These studies compared patients who experienced ORADEs and patients who did not (control group). Of these, 13 studies 11‐13,20‐29 involved a total of 1,887,711 surgical patients, one study 30 involved 731,208 medical patients, and two studies 31,32 involved a total of 355 hospitalized patients without stating the specialty (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…With respect to ORADEs investigated, seven studies 25,26,28‐32 focused on risk factors for over‐sedation and respiratory depression as they used administration of naloxone as their indicator for such ORADEs. Nine studies 11‐13,20‐24,27 focused on a combination of general ORADEs based on ICD codes (eg, respiratory, gastrointestinal, central nervous system, and genitourinary) (Table 2). These risk factors have been stratified to low‐moderate risk and high risk (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…Nine studies 11‐13,20‐24,27 focused on a combination of general ORADEs including respiratory, gastrointestinal, central nervous system, genitourinary, and pruritus. Of these, seven studies 11,12,20‐23,27 used ICD codes that are commonly associated with the ORADEs as stated above and two studies 13,24 also combined the use of naloxone administration as a surrogate.…”

Section: Resultsmentioning

confidence: 99%

“…Patients were more likely to experience general ORADEs if they had a higher overall comorbidity burden, which could be reflected by a higher Charlson Comorbidity Index (CCI) or Elixhauser Comorbidity Score 11,13,24 . Among all comorbid medical conditions, chronic obstructive pulmonary disease (COPD) was consistently revealed to be a risk factor for general ORADEs, which increased the risk by 1.2–2.3 times 12,20‐22,27 . Psychiatric disorders which included anxiety, depression, and mood orders were also commonly reported 13,20‐23,27 and increased the risk for general ORADEs by 16–21% 20‐23 .…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Patient risk factors for opioid‐related adverse drug events in hospitalized patients: A systematic review

et al. 2022

View full text Add to dashboard Cite

IntroductionOpioid utilization has increased fourfold over the past two decades among developed countries. Previous studies have found that opioid‐related adverse drug events (ORADEs) are strongly associated with adverse clinical outcomes in hospitalized patients. The Society of Hospital Medicine in the United States recently published a Consensus Statement regarding opioid safety and suggested that extra caution is needed when using opioids in patients with risk factors for ORADEs. This systematic review aimed to summarize common patient risk factors for ORADEs in hospitalized patients.MethodsFive databases were searched including Medline, Embase, Cochrane Central Register of Controlled Trials, International Pharmaceutical Abstracts, and Scopus. Search themes include opioids, adverse drug events, and acute care settings. Original full‐text studies that were published and identified patient risk factors for ORADEs in hospitalized patients were included.ResultsA total of 16 observational studies were included, with only two studies considered as poor quality. Seven studies focused on severe ORADEs including over‐sedation and respiratory depression. Common patient risk factors for severe ORADEs included comorbidities (eg, sleep apnea and renal diseases), concurrent use of sedatives, and prior opioid exposure. Nine studies focused on a combination of general ORADEs and common patient risk factors included advanced age, male gender, comorbidities (eg, chronic obstructive pulmonary disease and neurologic disorders), concurrent use of sedating medications, and prior opioid exposure. ConclusionsSuccessful identification of patient risk factors for ORADEs summarized by this systematic review could benefit clinicians when deciding on the appropriateness of opioid therapy in hospital patients. Future studies could focus on developing a validated risk assessment tool based on these risk factors.

show abstract

Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Patient risk factors for opioid‐related adverse drug events in hospitalized patients: A systematic review

et al. 2022

View full text Add to dashboard Cite

show abstract

Impact of opioids on hospital stay and mortality in patients undergoing abdominal surgeries

Maia,

Chaves,

Medeiros

et al. 2024

APS

View full text Add to dashboard Cite

Purpose Postoperative pain management is a critical aspect of surgical care, significantly influencing patient recovery and outcomes. This study aims to evaluate the impact of opioid use on hospital stay and mortality rates among patients undergoing abdominal surgeries in Brazil, where healthcare disparities may affect postoperative outcomes. Methods This observational cross-sectional study was conducted at the University Hospital Onofre Lopes in Natal, Brazil. We included 385 patients aged 18 years or older who underwent abdominal surgery in 2023. Data were collected from medical records, focusing on analgesic therapy, opioid types, dosages, and patient demographics. Statistical analyses were performed using JAMOVI software. Results Opioid consumption was prevalent among the cohort, with 89.6% of patients receiving opioids postoperatively. Tramadol was the most frequently administered opioid, followed by nalbuphine and morphine. Patients treated with morphine had a significantly extended median hospital stay (15.5 days) compared to those receiving tramadol or nalbuphine (2 days). Morphine use was also associated with a higher mortality rate, with these patients being 16 times more likely to die compared to those on weaker opioids. Older age and extended hospital stays were additional risk factors for increased mortality. Conclusion Opioids were used extensively in this cohort as the main analgesic drug for postoperative pain management after abdominal surgeries. Use was associated with prolonged hospital stay and higher probability of death.

show abstract

Mini-dose esketamine–dexmedetomidine combination to supplement analgesia for patients after scoliosis correction surgery: a double-blind randomised trial

Zhang

Cui

et al. 2023

British Journal of Anaesthesia

View full text Add to dashboard Cite

Potential opioid-related adverse events following spine surgery in elderly patients

Cited by 17 publications

References 35 publications

Patient risk factors for opioid‐related adverse drug events in hospitalized patients: A systematic review

Patient risk factors for opioid‐related adverse drug events in hospitalized patients: A systematic review

Impact of opioids on hospital stay and mortality in patients undergoing abdominal surgeries

Mini-dose esketamine–dexmedetomidine combination to supplement analgesia for patients after scoliosis correction surgery: a double-blind randomised trial

Contact Info

Product

Resources

About