Evidence map›Paper›PMID 34480941›Full record

ArticleUrology2021

Opioid-Free Discharge is Not Associated With Increased Unplanned Healthcare Encounters After Ureteroscopy: Results From a Statewide Quality Improvement Collaborative.

Scott R Hawken, Spencer C Hiller, Stephanie Daignault-Newton, Khurshid R Ghani, John M Hollingsworth, Bronson Conrado, Conrad Maitland, David L Wenzler, John K Ludlow, Sapan N Ambani and 3 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Urology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.6field-weighted citation impact, top 11% 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

7 citing papers in PubMed, 20 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
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  7. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Scott R HawkenDepartment of Urology, University of Michigan, Ann Arbor, MI.
Spencer C HillerDepartment of Urology, University of Michigan, Ann Arbor, MI.
Stephanie Daignault-NewtonDepartment of Urology, University of Michigan, Ann Arbor, MI.
Khurshid R GhaniDepartment of Urology, University of Michigan, Ann Arbor, MI.
John M HollingsworthDepartment of Urology, University of Michigan, Ann Arbor, MI.
Bronson ConradoDepartment of Urology, University of Michigan, Ann Arbor, MI.
Conrad MaitlandSherwood Medical Center, Detroit, MI.
David L WenzlerComprehensive Urology, Royal Oak, MI.
John K LudlowWestern Michigan Urological Associates, Holland, MI.
Sapan N AmbaniDepartment of Urology, University of Michigan, Ann Arbor, MI.
Chad M BrummettDepartment of Anesthesiology, University of Michigan, Ann Arbor, MI.
Casey A DauwDepartment of Urology, University of Michigan, Ann Arbor, MI. Electronic address: caseydau@med.umich.edu.
Michigan Urological Surgery Improvement Collaborative
University of Michigan–Ann Arbor · USComprehensive Urology · US

Funding

Real-world effectiveness of preventive pharmacological therapy for patients with kidney stonesR01DK121709 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLINGSWORTH, JOHN MALCOLM, SHAHINIAN, VAHAKN B · 2020 to 2024
$3.0M
NIDDK NIH HHS R01 DK121709
6 · The paper itself

Abstract

objectivesTo evaluate patient factors associated with post-ureteroscopy opioid prescriptions, provider-level variation in opioid prescribing, and the relationship between opioid-free discharges and ED visits.

methodsThis is a retrospective analysis of a prospective cohort study of adults age 18 years and older who underwent primary ureteroscopy for urinary stones from June 2016 to September 2019 within the Michigan Urological Surgery Improvement Collaborative (MUSIC) Reducing Operative Complications from Kidney Stones (ROCKS) quality improvement initiative. Postoperative opioid prescription trends and variation among practices and surgeons were examined. Multivariable logistic regression models defined risk factors for receipt of opioid prescriptions. The association among opioid prescriptions and postoperative ED visits within 30 days of surgery was assessed among complete case and propensity matched cohorts, matched on all measured characteristics other than opioid receipt.

results13,143 patients underwent ureteroscopy with 157 urologists across 28 practices. Post-ureteroscopy opioid prescriptions and ED visits declined (86% to 39%, P<.001; 10% to 6%, P<.001, respectively). Practice and surgeon-level opioid prescribing varied from 8% to 98%, and 0% to 98%, respectively. Patient-related factors associated with opioid receipt included male, younger age, and history of chronic pain. Procedure-related factors associated with opioid receipt included pre- and post-ureteroscopy ureteral stenting and access sheath use. An opioid-free discharge was not associated with increased odds of an ED visit (OR 0.77, 95% CI 0.62-0.95, P=.014).

conclusionsThere was no increase in ED utilization among those not prescribed an opioid after ureteroscopy, suggesting their routine use may not be necessary in this setting.

Indexed as

Patient DischargeQuality ImprovementUreteroscopyAdultAgedAnalgesics, OpioidDrug PrescriptionsEmergency Service, HospitalFemaleHumansMaleMiddle AgedPatient ReadmissionPostoperative PainProspective StudiesRetrospective StudiesAnalgesics, Opioid

Identifiers

PMID34480941
PMCPMC8671211
OpenAlexW3197758244

What OpenQuestion holds

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Registered trials

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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.