Evidence map›Paper›PMID 41858606›Full record

ArticleLancet regional health. Americas2026

Post-discharge opioid prescribing after surgery in the United States: a population-based analysis of specialty variation and prescribing intensity.

Adriana C Panayi, Dany Y Matar, Thomas Schaschinger, Tobias Niederegger, Jule Brandt, Iman Ghanad, Dennis P Orgill, Gabriel Hundeshagen

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Lancet regional health. Americas, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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. Article
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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.

Adriana C PanayiDepartment of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, University of Zurich, Rämistrasse 100, Zurich, 8091, Switzerland.
Dany Y MatarDepartment of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Thomas SchaschingerMedical Faculty, University of Heidelberg, Heidelberg, Germany.
Tobias NiedereggerMedical Faculty, University of Heidelberg, Heidelberg, Germany.
Jule BrandtMedical Faculty, University of Heidelberg, Heidelberg, Germany.
Iman GhanadDepartment of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Dennis P OrgillDivision of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Gabriel HundeshagenBG Klinik Ludwigshafen, Department of Hand, Plastic, and Reconstructive Surgery, Burn Center at Heidelberg University, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The transition from hospital to home after surgery is a vulnerable period, yet post-discharge opioid prescribing varies widely across surgical specialties. This study aimed to characterize these prescribing patterns and evaluate their implications for early postoperative outcomes. Methods: We performed a retrospective cohort study using the 2024 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Adult surgical patients who survived to discharge and had complete discharge analgesic data were included. Opioid prescribing was characterized by daily morphine milligram equivalents (MME), cumulative dose, duration, route, dosing frequency, and renewals. Multivariable regression adjusted for demographics, comorbidities, specialty, operative characteristics, and outcomes. Findings: Among 945,505 surgical patients, 683,828 (72.3%) were discharged with an opioid prescription. Prescribing varied by specialty and procedure, with a mean daily dose of 44.8 MME (Standard deviation, SD 122.1), mean duration of 4.2 days (SD 3.3), and prescription renewals in 28,385 (4.2%) patients. Patients discharged with opioids had shorter hospital stays (2.0 vs 3.3 days; p < 0.001) and lower rates of complications (7.7% vs 11.0%; p < 0.0001), reflecting preferential prescribing among clinically stable patients. Surgical specialty and anesthesia type were the strongest predictors of prescribing intensity, with higher odds of high-intensity prescribing following orthopedic (adjusted Odds Ratio, aOR 6.79, 95% Confidence Interval, CI 6.64-6.93) and neurosurgical procedures (aOR 5.66, CI 5.50-5.83), and spinal anesthesia (aOR 2.27, CI 2.21-2.33; all p < 0.001). Interpretation: Despite national efforts to reduce opioid use, most surgical patients continue to receive opioids at discharge, with specialty-specific variation. Differences in early postoperative outcomes should be interpreted as markers of clinical selection and recovery trajectory rather than evidence of opioid-related benefit. Procedure-specific, recovery-informed prescribing guidelines are needed to minimize avoidable opioid prescribing while ensuring adequate analgesia. Funding: None.

Indexed as

Critical careOpioidsPrognosticQuality improvementRisk factorSurgery

Identifiers

PMID41858606
PMCPMC12999286

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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.