Table 4.
Association between Preoperative Opioid Exposure and Respiratory-related Complications, Opioid-related Complications, Pain-related Complications, and General Readmissions within 30 days after Discharge
| Opioid-related Readmissions | Pain-related Readmissions | Respiratory-related Readmissions | General Readmissions | |||||
|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | p-value | OR (95% CI) | p-value | OR (95% CI) | p-value | OR (95% CI) | p-value | |
| Preop Opioid Exposure Group (Ref: Opioid-naïve) | ||||||||
| Minimal | 1.36 (1.00 1.85) | 0.052 | 1.12 (1.07 1.16) | <0.001 | 1.00 (0.94 1.06) | 0.974 | 1.00 (0.97 1.03) | 0.931 |
| Low | 1.63 (1.26 2.12) | <0.001 | 1.27 (1.23 1.32) | <0.001 | 1.10 (1.05 1.16) | <0.001 | 1.09 (1.06 1.12) | <0.001 |
| Moderate | 1.90 (1.38 2.61) | <0.001 | 1.40 (1.34 1.47) | <0.001 | 1.24 (1.16 1.32) | <0.001 | 1.16 (1.12 1.20) | <0.001 |
| High | 3.70 (2.71 5.04) | <0.001 | 1.62 (1.53 1.71) | <0.001 | 1.44 (1.34 1.55) | <0.001 | 1.23 (1.18 1.29) | <0.001 |
| Age, y (Ref: 65–69) | ||||||||
| 70–74 | 0.84 (0.66 1.09) | 0.188 | 1.06 (1.02 1.10) | 0.002 | 1.11 (1.05 1.17) | <0.001 | 1.08 (1.06 1.11) | <0.001 |
| 75–79 | 1.08 (0.83 1.41) | 0.577 | 1.17 (1.12 1.22) | <0.001 | 1.37 (1.30 1.44) | <0.001 | 1.23 (1.20 1.27) | <0.001 |
| 80–84 | 1.16 (0.85 1.58) | 0.343 | 1.32 (1.26 1.38) | <0.001 | 1.51 (1.43 1.61) | <0.001 | 1.41 (1.36 1.46) | <0.001 |
| ≥85 | 1.40 (0.98 1.99) | 0.065 | 1.55 (1.47 1.63) | <0.001 | 1.92 (1.79 2.05) | <0.001 | 1.64 (1.58 1.71) | <0.001 |
| Female (Ref: Male) | 1.14 (0.93 1.41) | 0.204 | 1.00 (0.97 1.02) | 0.714 | 0.92 (0.88 0.96) | <0.001 | 0.82 (0.81 0.84) | <0.001 |
| Race (Ref: White) | ||||||||
| Black | 0.92 (0.60 1.40) | 0.696 | 1.27 (1.20 1.33) | <0.001 | 1.05 (0.97 1.12) | 0.229 | 1.28 (1.23 1.33) | <0.001 |
| Hispanic | 0.98 (0.61 1.55) | 0.919 | 0.92 (0.86 0.97) | 0.005 | 0.69 (0.63 0.75) | <0.001 | 0.96 (0.92 1.01) | 0.084 |
| Other | 1.24 (0.67 2.26) | 0.495 | 0.97 (0.89 1.05) | 0.421 | 0.74 (0.66 0.84) | <0.001 | 0.98 (0.92 1.04) | 0.439 |
| Missing | 2.33 (0.95 5.71) | 0.065 | 0.86 (0.69 1.07) | 0.177 | 0.68 (0.48 0.97) | 0.036 | 0.83 (0.70 0.97) | 0.021 |
| Medicaid eligibility (Ref: No) | 0.68 (0.51 0.91) | 0.009 | 1.29 (1.24 1.34) | <0.001 | 1.64 (1.56 1.71) | <0.001 | 1.33 (1.29 1.36) | <0.001 |
| Charlson Comorbidity Index (Ref: None (CCI 0)) | ||||||||
| Mild (CCI 1, 2) | 0.88 (0.68 1.15) | 0.342 | 1.19 (1.15 1.24) | <0.001 | 1.50 (1.41 1.60) | <0.001 | 1.20 (1.17 1.24) | <0.001 |
| Moderate (CCI 3, 4) | 0.96 (0.72 1.30) | 0.802 | 1.37 (1.31 1.43) | <0.001 | 1.98 (1.85 2.11) | <0.001 | 1.42 (1.38 1.47) | <0.001 |
| Severe (CCI ≥5) | 1.22 (0.90 1.66) | 0.205 | 1.71 (1.63 1.79) | <0.001 | 2.65 (2.48 2.84) | <0.001 | 1.84 (1.78 1.90) | <0.001 |
| History of tobacco use (Ref: Non-smoker) | 1.26 (1.00 1.60) | 0.052 | 1.13 (1.09 1.17) | <0.001 | 1.49 (1.43 1.56) | <0.001 | 1.12 (1.09 1.15) | <0.001 |
| Surgery type None (Ref: Minor) | ||||||||
| Major | 1.90 (1.53 2.36) | <0.001 | 1.21 (1.17 1.24) | <0.001 | 1.19 (1.15 1.24) | <0.001 | 1.20 (1.17 1.22) | <0.001 |
| Mental Health Disorders | ||||||||
| Adjustment (Ref: No) | 1.60 (1.03 2.50) | 0.037 | 1.01 (0.92 1.10) | 0.878 | 0.94 (0.83 1.06) | 0.327 | 1.02 (0.95 1.09) | 0.554 |
| Anxiety | 1.20 (0.94 1.54) | 0.147 | 1.16 (1.12 1.21) | <0.001 | 1.14 (1.08 1.20) | <0.001 | 1.13 (1.10 1.17) | <0.001 |
| Mood | 1.15 (0.90 1.46) | 0.267 | 1.19 (1.15 1.23) | <0.001 | 1.19 (1.13 1.25) | <0.001 | 1.17 (1.14 1.20) | <0.001 |
| Suicide or self-harm | 1.24 (0.43 3.55) | 0.687 | 1.43 (1.15 1.78) | 0.001 | 1.03 (0.76 1.39) | 0.838 | 1.38 (1.15 1.66) | 0.001 |
| Disruptive | 1.83 (0.84 3.98) | 0.128 | 1.00 (0.83 1.20) | 0.960 | 0.86 (0.67 1.12) | 0.264 | 1.05 (0.91 1.21) | 0.532 |
| Personality | 1.38 (0.48 3.94) | 0.551 | 1.12 (0.88 1.41) | 0.362 | 0.95 (0.69 1.30) | 0.745 | 1.21 (1.01 1.46) | 0.042 |
| Psychosis | 1.41 (0.90 2.22) | 0.132 | 1.16 (1.08 1.25) | <0.001 | 1.33 (1.21 1.45) | <0.001 | 1.19 (1.12 1.27) | <0.001 |
| Alcohol or other substance use disorders | 2.44 (1.77 3.37) | <0.001 | 1.20 (1.12 1.29) | <0.001 | 0.99 (0.90 1.09) | 0.860 | 1.19 (1.12 1.25) | <0.001 |
| Other Mental Disorders | 1.55 (1.06 2.27) | 0.023 | 1.18 (1.10 1.27) | <0.001 | 1.10 (1.00 1.21) | 0.057 | 1.12 (1.06 1.18) | <0.001 |
| Pain Disorders | ||||||||
| Arthritis (Ref: No) | 1.38 (0.96 1.97) | 0.083 | 1.16 (1.11 1.21) | <0.001 | 0.89 (0.84 0.94) | <0.001 | 0.89 (0.87 0.92) | <0.001 |
| Back | 1.04 (0.85 1.28) | 0.696 | 1.14 (1.11 1.18) | <0.001 | 1.01 (0.97 1.06) | 0.528 | 1.06 (1.04 1.08) | <0.001 |
| Neck | 1.11 (0.87 1.40) | 0.403 | 1.02 (0.98 1.06) | 0.299 | 0.96 (0.91 1.01) | 0.112 | 0.98 (0.95 1.00) | 0.087 |
| Other pain | 1.14 (0.93 1.39) | 0.203 | 1.22 (1.19 1.26) | <0.001 | 1.18 (1.13 1.22) | <0.001 | 1.15 (1.13 1.18) | <0.001 |
| Any hospitalization in previous year (Ref: No) | 1.12 (0.88 1.43) | 0.367 | 1.28 (1.24 1.32) | <0.001 | 1.46 (1.40 1.53) | <0.001 | 1.36 (1.33 1.40) | <0.001 |
| Skilled nursing facility stay in previous year (Ref: No) | 1.32 (0.91 1.91) | 0.151 | 0.99 (0.94 1.06) | 0.853 | 1.15 (1.06 1.23) | <0.001 | 1.02 (0.98 1.08) | 0.323 |
| Benzo and Opioid filled concurrently during periop period (Ref: No) | 2.08 (1.55 2.78) | <0.001 | 1.19 (1.12 1.26) | <0.001 | 1.01 (093 1.11) | 0.774 | 1.13 (1.08 1.19) | <0.001 |