Predictors of postoperative opioid use in ventral and incisional hernia repair

Do Hyun Yun; Margaret A. Plymale; Douglas R. Oyler; Svetla S. Slavova; Daniel L. Davenport; John Scott Roth

doi:10.1007/s00464-024-10808-9

Predictors of postoperative opioid use in ventral and incisional hernia repair

Do Hyun Yun
, Margaret A. Plymale
, Douglas R. Oyler
, Svetla S. Slavova
, Daniel L. Davenport
, John Scott Roth

Research output: Contribution to journal › Article › peer-review

Abstract

Background: One in two ventral and incisional hernia repair (VIHR) patients have preoperative opioid prescription within a year before procedure. The study's aim was to investigate risk factors of increased postoperative prescription filling in patients with or without preoperative opioid prescription. Methods: VIHR cases from 2013 to 2017 were reviewed. State prescription drug monitoring program data were linked to patient records. The primary endpoint was cumulative opioid dose dispensed through post-discharge day 45. Morphine milligram equivalent (MME) was used for uniform comparison. Results: 205 patients were included in the study (average age 53.5 years; 50.7% female). Over 35% met criteria for preoperative opioid use. Preoperative opioid tolerance, superficial wound infection, current smoking status, and any dispensed opioids within 45 days of admission were independent predictors for increased postoperative opioid utilization (p < 0.001). Conclusion: Preoperative opioid use during 45-day pre-admission correlated strongly with postoperative prescription filling in VIHR patients, and several independent risk factors were identified.

Original language	English
Pages (from-to)	3052-3060
Number of pages	9
Journal	Surgical Endoscopy
Volume	38
Issue number	6
DOIs	https://doi.org/10.1007/s00464-024-10808-9
State	Published - Jun 2024

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.

Funding

We acknowledge the support from the Kentucky All Schedule Prescription Electronic Reporting (KASPER) program, Office of Inspector General, Kentucky Cabinet for Health and Family Services. This study was partially supported by Grant No. 2018-PM-BX-K051 awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the U.S. Department of Justice’s Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the SMART Office. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice. This project was undertaken through the Professional Student Mentored Research Fellowship (PSMRF) Program, which is supported by the National Center for Advancing Translational Sciences through Grant UL1TR001998, UK HealthCare and the University of Kentucky College of Medicine. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Dr. John Scott Roth discloses the following: grants from Beckton Dickinson & Company, Gore, and Advanced Medical Solutions (paid to institution); consulting for Beckton Dickinson & Company, Medtronic, and AbbVie (Allergan). Dr. Douglas R. Oyler discloses the following: consulting for Pharmerica, KY Hospital Association; honoraria from: American Society of Health System Pharmacists, University of Texas at Austin (2020), TRC HealthCare (2020); and grants from: NIH: UM1DA049406 (Co-Investigator, ongoing); FDA: HHSF223201810183C (Co-Investigator, completed); USDOJ: 2018-PM-BX-K051 (PI, ongoing); BJA-2017–11447 (Co-Investigator, completed); KY Cabinet for Health and Family Services. PON2 746 2000004006 (PI, completed), PON2 726 1900002839 (Co-Investigator, completed), PON2 729 1800000576 (Co-Investigator, completed). The other authors (Drs. Margaret A. Plymale, Daniel L. Davenport, and Svetla S. Slavova and Mr. Do Hyun (Daniel) Yun) have no conflicts of interest or financial ties to disclose.

Funders	Funder number
Kentucky All Schedule Prescription Electronic Reporting
Bureau of Justice Assistance
American Society of Health-System Pharmacists
University of Texas at Austin
Office of Inspector General
TRC Healthcare
University of Kentucky College of Medicine
Kentucky Cabinet for Health and Family Services
KY Cabinet for Health and Family Services
Professional Student Mentored Research Fellowship
PSMRF
National Center for Advancing Translational Sciences (NCATS)	UL1TR001998
National Institutes of Health (NIH)	HHSF223201810183C, 2018-PM-BX-K051, UM1DA049406, BJA-2017–11447

Keywords

Hernia repair
Opioid
Preoperative opioid use
Tolerance

ASJC Scopus subject areas

Surgery

Access to Document

10.1007/s00464-024-10808-9

Cite this

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title = "Predictors of postoperative opioid use in ventral and incisional hernia repair",

abstract = "Background: One in two ventral and incisional hernia repair (VIHR) patients have preoperative opioid prescription within a year before procedure. The study's aim was to investigate risk factors of increased postoperative prescription filling in patients with or without preoperative opioid prescription. Methods: VIHR cases from 2013 to 2017 were reviewed. State prescription drug monitoring program data were linked to patient records. The primary endpoint was cumulative opioid dose dispensed through post-discharge day 45. Morphine milligram equivalent (MME) was used for uniform comparison. Results: 205 patients were included in the study (average age 53.5 years; 50.7\% female). Over 35\% met criteria for preoperative opioid use. Preoperative opioid tolerance, superficial wound infection, current smoking status, and any dispensed opioids within 45 days of admission were independent predictors for increased postoperative opioid utilization (p < 0.001). Conclusion: Preoperative opioid use during 45-day pre-admission correlated strongly with postoperative prescription filling in VIHR patients, and several independent risk factors were identified.",

keywords = "Hernia repair, Opioid, Preoperative opioid use, Tolerance",

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note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.",

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month = jun,

doi = "10.1007/s00464-024-10808-9",

language = "English",

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AU - Plymale, Margaret A.

AU - Oyler, Douglas R.

AU - Slavova, Svetla S.

AU - Davenport, Daniel L.

AU - Roth, John Scott

N1 - Publisher Copyright: © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024.

PY - 2024/6

Y1 - 2024/6

N2 - Background: One in two ventral and incisional hernia repair (VIHR) patients have preoperative opioid prescription within a year before procedure. The study's aim was to investigate risk factors of increased postoperative prescription filling in patients with or without preoperative opioid prescription. Methods: VIHR cases from 2013 to 2017 were reviewed. State prescription drug monitoring program data were linked to patient records. The primary endpoint was cumulative opioid dose dispensed through post-discharge day 45. Morphine milligram equivalent (MME) was used for uniform comparison. Results: 205 patients were included in the study (average age 53.5 years; 50.7% female). Over 35% met criteria for preoperative opioid use. Preoperative opioid tolerance, superficial wound infection, current smoking status, and any dispensed opioids within 45 days of admission were independent predictors for increased postoperative opioid utilization (p < 0.001). Conclusion: Preoperative opioid use during 45-day pre-admission correlated strongly with postoperative prescription filling in VIHR patients, and several independent risk factors were identified.

AB - Background: One in two ventral and incisional hernia repair (VIHR) patients have preoperative opioid prescription within a year before procedure. The study's aim was to investigate risk factors of increased postoperative prescription filling in patients with or without preoperative opioid prescription. Methods: VIHR cases from 2013 to 2017 were reviewed. State prescription drug monitoring program data were linked to patient records. The primary endpoint was cumulative opioid dose dispensed through post-discharge day 45. Morphine milligram equivalent (MME) was used for uniform comparison. Results: 205 patients were included in the study (average age 53.5 years; 50.7% female). Over 35% met criteria for preoperative opioid use. Preoperative opioid tolerance, superficial wound infection, current smoking status, and any dispensed opioids within 45 days of admission were independent predictors for increased postoperative opioid utilization (p < 0.001). Conclusion: Preoperative opioid use during 45-day pre-admission correlated strongly with postoperative prescription filling in VIHR patients, and several independent risk factors were identified.

KW - Hernia repair

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KW - Preoperative opioid use

KW - Tolerance

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Predictors of postoperative opioid use in ventral and incisional hernia repair

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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