Steve October 21, 2020
opioid-use-increases-risk-of-death-in-older-adults-after-outpatient-surgery,-study-says

Oct. 21 (UPI) — Older adults who used opioid pain medications before minor surgery were up to 68% more likely to die within 90 days of the procedure compared with those who never used the drugs, an analysis published Wednesday by JAMA Surgery found.

Even among people older than 65 who had low levels of opioid use as long as eight months before surgery, about 55 people per 10,000 in the general population died within 90 days of having a procedure, the data showed.

Older adults who had not used opioid pain drugs prior to surgery died at a rate of just over 40 per 10,000 in the general population within 90 days of having a minor procedure, the researchers said.

“People who have preoperative exposure to opioids have a higher risk of mortality after outpatient surgery,” study co-author Dr. Katherine Santosa told UPI.

“Although our analysis cannot discern the underlying causes for this, our findings highlight the need to screen for opioid-related risk prior to surgery,” said Santosa, a surgeon at Michigan Medicine.

Opioids were the leading cause of drug overdose deaths in the United States in the first half of 2019, according to data released recently by the U.S. Centers for Disease Control and Prevention.

Much of the country has been in the grips of an “epidemic” of illegal opioid use and overdose deaths over the past 40 years, causing more than 1 million deaths, based on agency estimates.

At least some of this increase in use has been attributed to over-prescription for pain treatment, the CDC has said.

For this study, Santosa and her colleagues reviewed data on more than 99,000 Medicare beneficiaries — age 65 and older — who had outpatient surgical procedures between 2009 and 2015.

Outpatient procedures do not entail an overnight hospital stay, and patients are admitted, have surgery and are discharged the same day.

Patients included in the analysis had procedures ranging from varicose vein removal and hemorrhoid removal to trans-urethral prostate surgery, thyroid removal, carpal tunnel release, umbilical hernia repair and inguinal hernia repair, the researchers said.

Among outpatient surgery patients included in the study, 0.48% died within 90 days of having their procedure, the data showed.

However, those with “high” levels of opioid use — for 10 months or more and within one month — before surgery were 68% more likely to die within 90 days of their procedure, the researchers said.

In addition, those with low or medium use before surgery were 30% more likely to die, the data showed.
“Many Americans currently use opioids prior to surgery for a variety of conditions,” Santosa said.

“In this context, it is important to understand the potential impact of opioids on recovery, and create care pathways to decrease the risk of adverse effects [while undergoing surgery],” she said.

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