Table 3. Subgroup Analysis of Primary Outcomes by Type of Procedurea.
| Surgical procedure | No. of patients | No. (%) of patients with postoperative long-term opioid use | Patients with preoperative benzodiazepine use | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Long-term | Intermittent | ||||||||
| No. (%) of patients | Postoperative long-term opioid use, OR (95% CI) | Difference in average daily dose of opioid during postoperative days 91-365 (95% CI) | No. (%) of patients | Postoperative long-term opioid use, OR (95% CI) | Difference in average daily dose of opioid during postoperative days 91-365 (95% CI) | ||||
| Total arthroplasty | |||||||||
| Knee | 60 867 | 15 727 (25.8) | 1801 (3.0) | 1.62 (1.47 to 1.80)b | 0.7 (−0.3 to 1.7) | 2943 (4.8) | 1.44 (1.33 to 1.56)b | −0.1 (−0.9 to 0.7) | |
| Hip | 33 172 | 5323 (16.0) | 806 (2.4) | 1.92 (1.62 to 2.27)b | 1.2 (0.0 to 2.4) | 1640 (4.9) | 1.48 (1.30 to 1.67)b | −0.2 (−1.1 to 0.8) | |
| Cholecystectomy | |||||||||
| Laparoscopic | 119 374 | 19 789 (16.6) | 3633 (3.0) | 1.62 (1.50 to 1.76)b | 0.5 (−0.2 to 1.2) | 8421 (7.1) | 1.48 (1.40 to 1.56)b | −0.2 (−0.7 to 0.3) | |
| Open | 5793 | 953 (16.5) | 165 (2.8) | 1.45 (0.98 to 2.20) | −1.1 (−7.4 to 5.1) | 274 (4.7) | 1.75 (1.31 to 2.34)b | 7.8 (3.4 to 12.1)b | |
| Appendectomy | |||||||||
| Laparoscopic | 39 109 | 5901 (15.1) | 695 (1.8) | 1.41 (1.16 to 1.70)b | 1.6 (0.6 to 2.6)c | 1829 (4.7) | 1.41 (1.25 to 1.59) | 0.2 (−0.5 to 0.8) | |
| Open | 8508 | 1228 (14.4) | 156 (1.8) | 1.31 (0.86 to 1.99) | −1.0 (−5.0 to 3.1) | 341 (4.0) | 1.58b (1.20 to 2.08) | −0.7 (−3.4 to 1.9) | |
| Cesarean delivery | 151 469 | 18 573 (12.3) | 360 (0.2) | 2.32 (1.8 to 2.90)b | 0.7 (−0.4 to 1.9) | 4728 (3.1) | 1.56 (1.44 to 1.68)b | 0.9 (0.5 to 1.3)b | |
| Functional endoscopic sinus surgery | 42 653 | 8312 (19.5) | 1234 (2.9) | 1.44 (1.26 to 1.64)b | −0.6 (−1.8 to 0.7) | 3479 (8.2) | 1.37 (1.26 to 1.49)b | −0.3 (−1.1 to 0.5) | |
| Cataract surgery | 446 613 | 51 953 (11.6) | 13 446 (3.0) | 1.59 (1.52 to 1.67)b | 0.5 (0.1 to 0.9)c | 19 960 (4.4) | 1.49 (1.43 to 1.55)b | −0.2 (−0.5 to 0.1) | |
| Transurethral resection of the prostate | 12 396 | 1794 (14.5) | 312 (2.5) | NAd | 1.5 (−0.7 to 3.7) | 557 (4.5) | NAd | 0.2 (−1.5 to 1.8) | |
| Mastectomy | 26 607 | 4456 (16.7) | 876 (3.3) | 1.73 (1.47 to 2.04)b | 1.0 (−0.7 to 2.8) | 3797 (14.3) | 1.36 (1.24 to 1.49)b | −0.5 (−1.5 to 0.5) | |
Abbreviations: NA, not applicable; OR, odds ratio.
a
Increased odds of opioid use in postoperative days 91 to 365 for both long-term and intermittent preoperative benzodiazepine users across most surgery types in our sample. However, additional associations between preoperative benzodiazepine use and the dose of postoperative opioid used in the same period was not found.
b
P < .001.
c
P < .01.
d
Regression models were unable to converge to generate coefficients for the variables of interest.