Persistent Opioid Use After Open Aortic Surgery: Risk Factors, Costs and Consequences

Abstract Background The incidence and financial impact of persistent opioid use (POU) after open aortic surgery is undefined. Methods Insurance claim data from opioid-naive patients who underwent aortic root replacement, ascending aortic replacement or transverse arch replacement from 2011 to 2017 were evaluated. Persistent opioid use was defined as filling an opioid prescription in the perioperative period and between 90 and 180 days after surgery. Postoperative opioid prescriptions, emergency room visits, readmissions and healthcare costs were quantified. Multivariable logistic regression identified risk factors for POU, and quantile regression quantified the impact of POU on postoperative healthcare costs. Results Among 3,240 opioid-naive patients undergoing open aortic surgery, 169 (5.2%) of patients had POU. In the univariate analysis, patients with POU were prescribed more perioperative opioids (375 vs. 225 morphine milligram equivalents, p Conclusions POU is a challenge after open aortic surgery and can have longer term impacts on healthcare payments and emergency room visits in the 6 months after surgery. Strategies to reduce outpatient opioid use after aortic surgery should be encouraged when feasible.