Relationship Between Potential Opioid‐Related Adverse Effects and Hospital Length of Stay in Patients Receiving Opioids After Orthopedic Surgery

Abstract

Constipation, emesis, and confusion were associated with increased p-LOS in patients receiving opioids after orthopedic surgery. In addition, there was a significant linear relationship between the number of adverse effects/patient and increased p-LOS, and the strength of the association increased as the number of adverse effects increased. Although the opioid dosages and adverse-effect rates were typical, these findings reinforce the need to balance pain management with risk of events.

Bupivacaine liposome injectable suspension compared with bupivacaine HCl for the reduction of opioid burden in the postsurgical setting

“…In one 2007 study, there was an increase of 7% and 10% in these parameters, respectively, in patients experiencing postsurgical ORAEs, compared with a matched control group who did not have ORAEs 10 . In a retrospective study of 402 patients undergoing orthopedic surgery, opioid-related AEs of constipation, confusion, and emesis were significantly associated with longer hospital stays (1.4, 1.1, and 0.7 additional days, respectively; p50.01 for all comparisons) compared with patients who did not experience these AEs 29 . Another analysis of data from nearly 320,000 inpatients who underwent colectomy, cholecystectomy, total abdominal hysterectomy, or hip replacement found that the group who experienced an ORAE (n ¼ 39,116) remained in the hospital an average of 3.3 days longer, and had average hospital costs that were about $4700 more than a control group without ORAEs (n ¼ 280,782) 30 .…”

Estimating the Effect of Intravenous Acetaminophen for Postoperative Pain Management on Length of Stay and Inpatient Hospital Costs

“…Less commonly, opioid monotherapy has been associated with ileus [16], respiratory depression [17], falls, and delirium, and in some extreme cases even death [18]. Numerous studies have demonstrated that managing these ORADEs is costly and they are associated with increased LOS [19–22]. …”

Predictors of naloxone use for respiratory depression and oversedation in hospitalized adults

“…Naloxone use for the treatment of opioid-induced respiratory depression was cited in 4.6% of all ADEs reported in one analysis. 7 Even with the availability of this antidote, opioid-induced adverse events can lead to increased costs of care due to an increased length of stay, 8 the need for additional medications, and lawsuits. 9 A study evaluating over 4000 patients admitted to two tertiary care hospitals found that the more seriAm J Health-Syst Pharm-Vol 71 May 1, 2014 ous ADEs were typically regarded as preventable.…”