Association Between Discharge Medications and Oncologic Post‐Embolization‐Syndrome‐Related Outcomes

Background Post‐embolization syndrome after transarterial chemoembolization (TACE) and Yttrium‐90 radioembolization (TARE) causes significant morbidity. Understanding whether discharge prescriptions influence short‐term outcomes may guide standardized pain‐management strategies. Methods A retrospective cohort study of 3191 patients (3988 procedures) with hepatocellular carcinoma from the Merative MarketScan Databases (2009–2022) was performed. The composite outcome was 7‐day drug escalation or hospital readmission. Bivariate logistic regression identified candidate variables ( p < 0.10); multivariable logistic regression with patient‐clustered robust standard errors estimated adjusted odds ratios (aORs), adjusting for age, sex, and Charlson Comorbidity Index (CCI). Results Compared to patients discharged without opioids post‐chemoembolization, those prescribed opioids at discharge had 83% lower odds of experiencing drug escalation or readmission (odds ratio [aOR] = 0.17, p < 0.001), and those undergoing radioembolization had 59% lower odds (aOR = 0.41, p < 0.001). Being prescribed antiemetics or steroids was also associated with lower odds of escalation/readmission events, with percentages varying by procedure type. Conclusions Prescribing opioids, along with antiemetics and steroids, at discharge may reduce the likelihood of post‐procedural events, such as drug escalation and readmission, in patients undergoing trans‐arterial chemoembolization and radioembolization for hepatocellular carcinoma. These findings highlight the importance of a comprehensive pain management strategy in interventional oncology and warrant consideration in clinical practice guidelines.