Post-procedure opioid-related ADEs deadly and costly

More than 10% of patients who receive opioids after surgery, endoscopic procedures experience ADEs

More than 10% of adults who undergo surgical or endoscopic procedures and receive opioids will have an opioid-related adverse drug event (ADE), according to a study published online in JAMA Surgery. Moreover, these adverse events were associated with an increased likelihood of poor outcomes.

Using ICD-9 codes for known adverse effects of opioids or for opioid-antagonist use, researchers identified opioid-related ADEs among 135,379 patients who had received opioids in 21 acute care hospitals in one health system. They found that 14,386, or 10.6%, of these patients experienced at least one opioid-related ADE, and that those who had such ADEs had received a higher total dose of opioids and had received opioids for a longer duration than those who did not experience an opioid-related ADE. Among these patients, 55.8% had at least one moderate ADE and 37.3% had at least one severe ADE.

Opioid-related ADEs were associated with a 2.9% increase in absolute mortality, an $8,225 increase in the cost of hospitalization, and a 1.6-day increase in length of hospital stay. Patients with opioid-related ADEs were also more likely to be discharged to another care facility or be readmitted within 30 days. The researchers extrapolated the average incremental cost per hospitalization over the entire study population that experienced opioid-related ADEs and estimated that these ADEs result in more than $118 million of variable and potentially avoidable costs to the health system over 3 years.