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October 29, 2020Heart

Impact of opioid use disorders on outcomes and readmission following cardiac operations

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Key result

Opioid use disorder is linked to ~44% higher 30-day readmission after cardiac surgery.

  • P<0.001
  • n=1,978,276

Why the study?

The impact of opioid use disorder on readmissions following cardiac operations was understudied despite known associations with increased morbidity and resource use.

Does opioid use disorder increase readmissions and complications in patients undergoing cardiac surgery?

Population

1,978,276 patients undergoing coronary artery bypass grafting and valve repair or replacement in the Nationwide Readmissions Database

Comparison

Patients with opioid use disorder vs patients without opioid use disorder

Design

Retrospective cohort study using Nationwide Readmissions Database

Follow-up

30 days

Authors

JMJosef MadrigalYSYas SanaihaJHJoseph Hadaya

Discussion

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Member takes

Overview

May warrant enhanced discharge planning for cardiac surgery patients with opioid use disorder; leaves open whether interventions reduce readmissions.

Study Design

Type

Cohort (n=1,978,276)

Multicenter

Yes

Structured PICO

Does opioid use disorder increase readmissions and complications in patients undergoing cardiac surgery?

P
Population
1,978,276 patients undergoing coronary artery bypass grafting or valve surgery (excluding infective endocarditis) from 2010 to 2016, assessed for 30-day readmission.
E
Exposure
Opioid use disorder (OUD)
C
Comparator
No opioid use disorder
O
Outcome
30-day readmission, mortality, complications, hospitalisation costs, and length of stayhard clinical

Main Result

Absolute Event Rate: 19% vs 13.2%

p-value: p=<0.001

Opioid use disorder in cardiac surgery patients is associated with higher rates of 30-day readmission, thromboembolic events, and infectious complications, highlighting the need for targeted predischarge interventions.

Cite This Study

Madrigal et al. (2020) conducted a cohort in Patients undergoing cardiac operations (n=1,978,276). Opioid use disorder vs. Patients without opioid use disorder was evaluated on 30-day readmission (p=<0.001). Opioid use disorder in patients undergoing cardiac surgery was associated with a higher rate of 30-day readmission (19.0% vs 13.2%, p<0.001) compared to those without the disorder.

synapsesocial.com/papers/6aadeb9cb47555f494a3535ehttps://doi.org/10.1136/heartjnl-2020-317618
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Chronic opioid use after coronary bypass surgery2019 · 28 citations
  2. 2Mortality Quadrupled Among Opioid-Driven Hospitalizations, Notably Within Lower-Income And Disabled White Populations2017 · 107 citations
  3. 3<i>Vital Signs</i>: Trends in Emergency Department Visits for Suspected Opioid Overdoses — United States, July 2016–September 20172018 · 434 citations
  4. 4A primer on model selection using the Akaike Information Criterion2020 · 513 citations
  5. 5Opioid Crisis: No Easy Fix to Its Social and Economic Determinants2017 · 932 citations