Table 2.
CPOU Incidence Cohorts: Baseline Characteristics of Matched Cohorts without Chronic Prescription Opioid Use at Baseline
| Open RYGB | Laparoscopic RYGB | Laparoscopic Sleeve Gastrectomy | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Non-surgical (n=7,424) |
Surgical (n=812) |
SMD | Non-surgical (n=7,216) |
Surgical (n=775) |
SMD | Non-surgical (n=11,752) |
Surgical (n=1,235) |
SMD | |
| VARIABLES USED IN MATCH | |||||||||
| Female, N (%) | 1,486 (20.0) | 187 (23.0) | 0.07 | 1,907 (26.4) | 225 (29.0) | 0.06 | 3,027 (25.8) | 341 (27.6) | 0.04 |
| Male, N (%) | 5,938 (80.0) | 625 (77.0) | 5,309 (73.6) | 550 (71.0) | 8,725 (74.2) | 894 (72.4) | |||
| Age, Mean (SD) | 52.4 (8.3) | 51.8 (8.5) | 0.07 | 53.3 (9.9) | 52.6 (10.1) | 0.07 | 52.7 (10.4) | 52.1 (10.4) | 0.05 |
| BMI, Mean (SD) | 46.9 (6.6) †† | 48.7 (7.8) | 0.24 | 43.6 (5.6) † | 44.5 (6.6) | 0.15 | 42.8 (5.3) | 43.4 (5.7) | 0.10 |
| Race, White, N (%) | 5,924 (79.8) | 636 (78.3) | 0.04 | 5,702 (79.0) | 602 (77.7) | 0.03 | 8,247 (70.2) | 856 (69.3) | 0.02 |
| Diagnosed Diabetes, N (%) | 4,026 (54.2) | 437 (53.8) | 0.01 | 4,244 (58.8) | 454 (58.6) | 0.00 | 6,336 (53.9) | 667 (54.0) | 0.00 |
| Unhealthy alcohol use at baseline, N (%) | 50 (0.7) | 7 (0.9) | 0.02 | 356 (4.9) | 43 (5.5) | 0.03 | 797 (6.8) | 98 (7.9) | 0.04 |
| Depression treatment at baseline, N (%) | 2,726 (36.7) | 318 (39.2) | 0.05 | 2,854 (39.6) | 315 (40.6) | 0.02 | 4,676 (39.8) | 504 (40.8) | 0.02 |
| Diagnosed alcohol use disorder at baseline, N (%) | 261 (3.5) | 39 (4.8) | 0.06 | 314 (4.4) | 42 (5.4) | 0.05 | 534 (4.5) | 72 (5.8) | 0.06 |
| Diagnosed opioid use disorder at baseline, N (%) | 3 (0.0) | 1 (0.1) | 0.03 | 6 (0.1) | 4 (0.5) | 0.08 | 9 (0.1) | 6 (0.5) | 0.08 |
| VARIABLES NOT USED IN MATCH | |||||||||
| NOSOS risk score in 20062015, Mean (SD) | 1.5 (1.0)† | 1.6 (0.9) | 0.15 | 1.4 (1.0) † | 1.5 (0.9) | 0.12 | 1.4 (1.0) | 1.5 (0.8) | 0.08 |
| DCG risk score in 2000-2005, Mean (SD) | 0.6 (0.6) | 0.6 (0.5) | 0.02 | 0.7 (0.6)† | 0.6 (0.5) | 0.16 | 0.9 (1.5) †† | 0.4 (0.2) | 0.44 |
| Married, N (%) | 3,127 (42.1) | 425 (52.3) | 3,144 (43.6) | 402 (51.9) | 5,014 (42.7) | 607 (49.1) | |||
| Previously married, N (%) | 2,044 (27.5) †† | 246 (30.3) | 0.31 | 2,116 (29.3) †† | 260 (33.5) | 0.31 | 3,576 (30.4) †† | 415 (33.6) | 0.24 |
| Unmarried or unknown, N (%) | 2,253 (30.3) | 141 (17.4) | 1,955 (27.1) | 113 (14.6) | 3,161 (26.9) | 213 (17.2) | |||
| VA Outpatient Mental Health Visits, Mean (SD) | 6.1 (19.2) | 6.6 (13.6) | 0.03 | 8.1 (20.4) | 9.4 (19.1) | 0.06 | 9.2 (22.4) | 9.2 (16.4) | 0.00 |
| VA Outpatient Visits, Mean (SD) | 14.1 (15.4) †† | 17.9 (14.4) | 0.25 | 14.1 (15.0) †† | 18.9 (13.6) | 0.34 | 14.0 (14.8) †† | 18.6 (13.4) | 0.32 |
| Non-VA Outpatient Visits, Mean (SD) | 0.3 (4.6) | 0.3 (1.6) | 0.01 | 0.4 (6.8) | 0.4 (1.2) | 0.01 | 0.3 (2.4) | 0.4 (1.0) | 0.02 |
| VA reliance, Mean (SD) | 1.0 (0.1) | 1.0 (0.1) | 0.01 | 1.0 (0.1) | 1.0 (0.1) | 0.03 | 1.0 (0.1) | 1.0 (0.1) | 0.00 |
| Diagnosed Hypertension, N (%) | 4,821 (64.9) †† | 603 (74.3) | 0.20 | 4,688 (65.0) † | 556 (71.7) | 0.15 | 7,373 (62.7) † | 863 (69.9) | 0.15 |
| Diagnosed Asthma, N (%) | 502 (6.8) | 61 (7.5) | 0.03 | 578 (8.0) | 80 (10.3) | 0.08 | 1,015 (8.6) | 131 (10.6) | 0.07 |
| Diagnosed Fatty Liver, N (%) | 20 (0.3) † | 11 (1.4) | 0.12 | 71 (1.0) | 13 (1.7) | 0.06 | 162 (1.4) | 30 (2.4) | 0.08 |
| Diagnosed PTSD, N (%) | 1,040 (14.0) | 116 (14.3) | 0.01 | 1,339 (18.6) | 152 (19.6) | 0.03 | 2,392 (20.4) | 261 (21.1) | 0.02 |
| Diagnosed Cannabis disorder, N (%) | 40 (0.5) | 7 (0.9) | 0.04 | 71 (1.0) | 5 (0.6) | 0.04 | 146 (1.2) | 6 (0.5) | 0.08 |
| Diagnosed Other drug disorder, N (%) | 142 (1.9) | 22 (2.7) | 0.05 | 165 (2.3) | 9 (1.2) | 0.09 | 315 (2.7) | 29 (2.3) | 0.02 |
| Diagnosed Anxiety, N (%) | 605 (8.1) | 67 (8.3) | 0.00 | 954 (13.2) | 121 (15.6) | 0.07 | 1,790 (15.2) | 188 (15.2) | 0.00 |
| Diagnosed Bipolar, N (%) | 291 (3.9) | 44 (5.4) | 0.07 | 354 (4.9) | 43 (5.5) | 0.03 | 609 (5.2) | 60 (4.9) | 0.01 |
| Diagnosed Psychosis, N (%) | 88 (1.2) | 7 (0.9) | 0.03 | 77 (1.1) | 6 (0.8) | 0.03 | 166 (1.4) † | 4 (0.3) | 0.12 |
| Diagnosed Schizophrenia, N (%) | 312 (4.2) † | 18 (2.2) | 0.11 | 276 (3.8) | 7 (0.9) | 0.19 | 395 (3.4) † | 17 (1.4) | 0.13 |
| Diagnosed Eating disorder, N (%) | 39 (0.5) | 12 (1.5) | 0.10 | 23 (0.3) | 13 (1.7) | 0.14 | 45 (0.4) † | 17 (1.4) | 0.11 |
| Diagnosed Tobacco Use disorder, N (%) | 807 (10.9) † | 59 (7.3) | 0.13 | 865 (12.0) †† | 42 (5.4) | 0.23 | 1,446 (12.3) † | 80 (6.5) | 0.20 |
| Diagnosed CAD, N (%) | 1,158 (15.6) | 124 (15.3) | 0.01 | 1,004 (13.9) | 94 (12.1) | 0.05 | 1,427 (12.1) | 140 (11.3) | 0.03 |
| Diagnosed dyslipidemia, N (%) | 3,256 (43.9) | 382 (47.0) | 0.06 | 4,173 (57.8) † | 497 (64.1) | 0.13 | 6,499 (55.3) | 741 (60.0) | 0.10 |
| Diagnosed GERD, N (%) | 1,098 (14.8) † | 173 (21.3) | 0.17 | 1,195 (16.6) †† | 234 (30.2) | 0.33 | 2,192 (18.7) † | 335 (27.1) | 0.20 |
| Non-recent depression diagnosis, N (%) | 1,514 (20.4) † | 211 (26.0) | 0.13 | 2,764 (38.3) | 328 (42.3) | 0.08 | 5,023 (42.7) | 577 (46.7) | 0.08 |
Abbreviations: SD, standard deviation; BMI, body mass index; PTSD, post-traumatic stress disorder; RYGB, Roux-en-Y gastric bypass; DCG, diagnosis cost group; MME, morphine milligram equivalent; SMD, standardized mean difference; GERD, gastroesophageal reflux disorder; CPOU, chronic prescription opioid use.
Note: Risk measures were not available the entire study period, so we relied on DCG from 2000-2005 and NOSOS from 2006-2015
†=
standardized mean difference > 0.10;
†† =
standardized mean difference > 0.20; a value <0.2 indicates reasonable balance.
*
All diagnoses were identified from inpatient and outpatient visit records using ICD-9 codes.
**
Standardized mean differences compare each covariate’s mean or proportion between the surgical cases and non-surgical controls in units of the pooled standard deviation.22