Table 4.
Sensitivity analysis of primary and secondary outcomes excluding controls who reported home opioid use*
| Outcome | IDDS (N=107) | Control (N=176) | p-value | Covariate adjusted† |
|
|---|---|---|---|---|---|
| Estimate (95% C.I.) | p-value | ||||
|
| |||||
| Opioid Utilization Outcomes | |||||
| Perioperative opioid, ml OME | 114 (60, 165) | 95 (45, 145) | 0.069 | 1.34 (1.07, 1.68) | 0.011 |
| Opioid first 24 hours post-PACU, ml OME | 75 (23, 283) | 58 (0, 200) | 0.006 | 2.48 (1.49, 4.10) | <0.001 |
| Any opioid first 24 hours post-PACU | 90 (84.1) | 117 (66.5) | 0.004 | 4.21 (1.70, 10.41) | 0.002 |
| Opioid first 72 hours post-PACU, ml OME | 195 (38, 652) | 124 (0, 407) | 0.007 | 2.68 (1.50, 4.79) | <0.001 |
| Any opioid first 72 hours post-PACU | 90 (84.1) | 124 (70.5) | 0.020 | 2.72 (1.20, 6.19) | 0.017 |
| Clinical Outcomes | |||||
| Escalating O2 Requirement | 84 (78.5) | 125 (71.0) | 0.259 | ||
| Naloxone Administration | 0 (0.0) | 2 (1.1) | 0.528‡ | ||
| Pain-Sedation mismatch | 1 (0.9) | 8 (4.6) | 0.160‡ | ||
| Pain medicine consult | 55 (51.4) | 10 (5.7) | <0.001 | ||
The analyses of the primary outcomes were repeated after excluding 33 controls who were indicated to have preoperative home opioid use. In addition, there were 5 IDDS patients who were also excluded because they no longer had any matched controls. Continuous outcomes are summarized using median (25th, 75th) and binary outcomes are summarized using n (%). Due to skewed distributions, opioid requirements were analyzed using a log transformation (log(OME + 1)). Continuous outcomes were analyzed using linear regression and binary outcomes were analyzed using logistic regression. Since multiple surgeries are included for some IDDS patients, analyses were performed using Generalized Estimating Equations (GEE) with robust variance estimates for all outcomes with the exception of naloxone administration and pain-sedation mismatch which were compared between groups using Fisher’s exact test.
Covariates were included for age, sex, BMI, Charlson comorbidity index, history of anxiety or depression, type of surgery, type of anesthetic, and duration of surgery. For opioid requirements expressed as a continuous variable the estimate presented corresponds to the multiplicative effect for IDDS relative to control. For binary outcomes the estimate presented corresponds to the odds ratio for IDDS relative to control.
Fisher’s exact test