Evidence map›Paper›PMID 31280840›Full record

ArticleAmerican journal of surgery2020

Perioperative opioid use and pain-related outcomes in the Veterans Health Administration.

Tina Hernandez-Boussard, Laura A Graham, Ian Carroll, Elise A Dasinger, Ashley L Titan, Melanie S Morris, Mary T Hawn

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Leveraging Digital Data to Inform and Improve Quality Cancer Care.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Tina Hernandez-BoussardDepartment of Medicine, Stanford University, Stanford, CA, USA; Department of Surgery, Stanford University, Stanford, CA, USA; Department of Biomedical Data Science, Stanford University, Stanford, CA, USA. Electronic address: boussard@stanford.edu.
Laura A GrahamDepartment of Surgery, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
Ian CarrollDepartment of Anesthesia, Stanford University, Stanford, CA, USA.
Elise A DasingerBirmingham VA Medical Center, Birmingham, AL, USA; Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Ashley L TitanDepartment of Surgery, Stanford University, Stanford, CA, USA.
Melanie S MorrisBirmingham VA Medical Center, Birmingham, AL, USA; Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Mary T HawnDepartment of Surgery, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.

Funding

Advancing Knowledge Discovery for Postoperative Pain ManagementR01LM013362 · NLM · STANFORD UNIVERSITY · PI HERNANDEZ-BOUSSARD, TINA · 2019 to 2023
$3.2M
Improving Quality of postoperative pain care through innovative use of electronic health recordsR01HS024096 · AHRQ · STANFORD UNIVERSITY · PI HERNANDEZ-BOUSSARD, TINA · 2015 to 2019
$1.1M
AHRQ HHS R01 HS024096NLM NIH HHS R01 LM013362
6 · The paper itself

Abstract

Understanding variation in perioperative opioid exposure and its effect on patients' outcomes is critical for pain management. This study characterized perioperative exposure to morphine and its association with postoperative pain and 30-day readmissions. We utilized nationwide Veterans Healthcare Administration (VHA) data on four high-volume surgical procedures, 2007-2014. We identified 235,239 Veterans undergoing orthopedic, general, or vascular surgery; 5.4% high trajectories (116.1 OME/Day), 53.2% medium trajectories (39.7 OME/Day), and 41.4% low trajectories (19.1 OME/Day). Modeled estimates suggest that patients in the high OME group had higher risk of a pain-related readmission (OR: 1.59; CI: 1.39, 1.83) compared to the low OME trajectory. Yet when stratified by pain trajectory, patients with high pain and high OME had lower risk of a pain-related readmission compared to patients in the high pain low OME group (OR: 0.76, CI: 0.62, 0.94). In conclusion, patients receiving high perioperative OME are more likely to return to care for pain-related problems. This study highlights opportunities to reduce the amount of prescriptions opioids in the communities.

Indexed as

Pain ManagementVeterans HealthAgedAnalgesics, OpioidCohort StudiesFemaleHumansMaleMiddle AgedMorphineOpioid-Related DisordersPatient ReadmissionPostoperative PainPreoperative PeriodRetrospective StudiesUnited StatesAnalgesics, OpioidMorphine

Identifiers

PMID31280840
PMCPMC10163865

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.