ArticleThe Annals of thoracic surgery2021
Establishment and Implementation of Evidence-Based Opioid Prescribing Guidelines in Cardiac Surgery.
Article in The Annals of thoracic surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Pooled it
- The association between the Distressed Communities Index and failure to rescue after cardiac surgery among Medicare beneficiaries.The Journal of thoracic and cardiovascular surgery · 2026Article
- Interhospital variation in Medicare spending for infections after coronary artery bypass grafting and surgical aortic valve replacement.JTCVS open · 2026Article
- Article
- Disparities in 180-day infection rates following coronary artery bypass grafting and aortic valve replacement.The Journal of thoracic and cardiovascular surgery · 2025Article
- Article
- An Institutional Curriculum for Opioid Prescribing Education: Outcomes From 2017 to 2022.The Journal of surgical research · 2024Article
- Advancing cardiotomy suction practices for coronary surgery via multidisciplinary collaborative learning.JTCVS open · 2024Article
- Interhospital variability in failure to rescue rates following aortic valve surgery.JTCVS open · 2023Article
- Evidence-based opioid prescribing guidelines after lung resection: a prospective, multicenter analysis.Journal of thoracic disease · 2023Article
- Radiomics Represent a New Opportunity for Bariatric Surgery When Implemented in a Quality Improvement Context.Obesity surgery · 2022Article
- Perioperative Opioids, the Opioid Crisis, and the Anesthesiologist.Anesthesiology · 2022Article
Corrections and comments
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Authors and funding
21 authors at 12 institutions in 1 country.
Funding
Abstract
backgroundDespite the risk of new persistent opioid use after cardiac surgery, postdischarge opioid use has not been quantified and evidence-based prescribing guidelines have not been established.
methodsOpioid-naive patients undergoing primary cardiac surgery via median sternotomy between January and December 2019 at 10 hospitals participating in a statewide collaborative were selected. Clinical data were linked to patient-reported outcomes collected at 30-day follow-up. An opioid prescribing recommendation stratified by inpatient opioid use on the day before discharge (0, 1-3, or ≥4 pills) was implemented in July 2019. Interrupted time-series analyses were performed for prescription size and postdischarge opioid use before (January to June) and after (July to December) guideline implementation.
resultsAmong 1495 patients (729 prerecommendation and 766 postrecommendation), median prescription size decreased from 20 pills to 12 pills after recommendation release (P < .001), while opioid use decreased from 3 pills to 0 pills (P < .001). Change in prescription size over time was +0.6 pill/month before and -0.8 pill/month after the recommendation (difference = -1.4 pills/month; P = .036). Change in patient use was +0.6 pill/month before and -0.4 pill/month after the recommendation (difference = -1.0 pills/month; P = .017). Pain levels during the first week after surgery and refills were unchanged. Patients using 0 pills before discharge (n = 710) were prescribed a median of 0 pills and used 0 pills, while those using 1 to 3 pills (n = 536) were prescribed 20 pills and used 7 pills, and those using greater than or equal to 4 pills (n = 249) were prescribed 32 pills and used 24 pills.
conclusionsAn opioid prescribing recommendation was effective, and prescribing after cardiac surgery should be guided by inpatient use.
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Registered trials
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