Evidence map›Paper›PMID 32394171›Full record

ArticleSurgical endoscopy2021

Preoperative opioid use is associated with increased risk of postoperative complications within a colorectal-enhanced recovery protocol.

Taryn E Hassinger, Elizabeth D Krebs, Florence E Turrentine, Robert H Thiele, Bethany M Sarosiek, Sook C Hoang, Charles M Friel, Traci L Hedrick

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 24% of its field
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. 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

8 authors at 1 institution in 1 country.

Taryn E HassingerDepartment of Surgery, University of Virginia Health System, P.O. Box 800300, Charlottesville, VA, 22908, USA. teh3rz@hscmail.mcc.virginia.edu.ORCID 0000-0003-3015-4126
Elizabeth D KrebsDepartment of Surgery, University of Virginia Health System, P.O. Box 800300, Charlottesville, VA, 22908, USA.
Florence E TurrentineDepartment of Surgery, University of Virginia Health System, P.O. Box 800300, Charlottesville, VA, 22908, USA.
Robert H ThieleDepartment of Anesthesiology, University of Virginia Health System, Charlottesville, VA, USA.
Bethany M SarosiekDepartment of Surgery, University of Virginia Health System, P.O. Box 800300, Charlottesville, VA, 22908, USA.
Sook C HoangDepartment of Surgery, University of Virginia Health System, P.O. Box 800300, Charlottesville, VA, 22908, USA.
Charles M FrielDepartment of Surgery, University of Virginia Health System, P.O. Box 800300, Charlottesville, VA, 22908, USA.
Traci L HedrickDepartment of Surgery, University of Virginia Health System, P.O. Box 800300, Charlottesville, VA, 22908, USA.
University of Virginia Health System · US

Funding

Postdoctoral Training Grant for MDs in Surgical Oncology ResearchT32CA163177 · NCI · UNIVERSITY OF VIRGINIA · PI Craig Lee Slingluff, Allan Tsung · 2011 to 2026
$4.6M
NIH HHS T32CA163177
6 · The paper itself

Abstract

backgroundAs the opioid epidemic escalates, preoperative opioid use has become increasingly common. Recent studies associated preoperative opioid use with postoperative morbidity. However, limited study of its impact on patients within enhanced recovery protocols (ERP) exists. We assessed the impact of preoperative opioid use on postoperative complications among colorectal surgery patients within an ERP, hypothesizing that opioid-exposed patients would be at increased risk of complications.

methodsElective colorectal cases from August 2013 to June 2017 were reviewed in a retrospective cohort study comparing preoperative opioid-exposed patients to opioid-naïve patients. Postoperative complications were defined as a composite of complications captured by the American College of Surgeons National Surgical Quality Improvement Program. Logistic regression identified risk factors for postoperative complications.

results707 patients were identified, including 232 (32.8%) opioid-exposed patients. Opioid-exposed patients were younger (57.9 vs 61.9 years; p < 0.01) and more likely to smoke (27.6 vs 17.1%; p < 0.01). Laparoscopic procedures were less common among opioid-exposed patients (44.8 vs 58.1%; p < 0.01). Median morphine equivalents received were higher in opioid-exposed patients (65.0 vs 20.1 mg; p < 0.01), but compliance to ERP elements was otherwise equivalent. Postoperative complications were higher among opioid-exposed patients (28.5 vs 15.0%; p < 0.01), as was median length of stay (4.0 vs 3.0 days; p < 0.01). Logistic regression identified multiple patient- and procedure-related factors independently associated with postoperative complications, including preoperative opioid use (p = 0.001).

conclusionPreoperative opioid use is associated with increased risk of postoperative complications in elective colorectal surgery patients within an ERP. These results highlight the negative impact of opioid use, suggesting an opportunity to further reduce the risk of surgical complications through ERP expansion to include preoperative mitigation strategies for opioid-exposed patients.

Indexed as

Analgesics, OpioidAgedColorectal NeoplasmsColorectal SurgeryElective Surgical ProceduresFemaleHumansLaparoscopyLength of StayMaleMiddle AgedOpioid-Related DisordersPostoperative ComplicationsPreoperative PeriodRetrospective StudiesTreatment OutcomeAnalgesics, OpioidColon and rectal surgeryEnhanced recoveryOpioidsPostoperative complications

Identifiers

PMID32394171
OpenAlexW3020871853

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.