November 06, 2020
Between 2010 and 2016, the prevalence of opioid use disorder among patients undergoing cardiac surgery increased threefold, from 0.15% to 0.53%, according to a study published online in the journal Heart.
“The prevalence of opioid use disorder among cardiac surgical patients has steeply increased over the past decade,” wrote researchers from the University of California Los Angeles and Los Angeles County Harbor-UCLA Medical Center.
The study looked at the effect of opioid use disorder on outcomes and hospital readmissions for patients who underwent coronary artery bypass grafting and valve repair or replacement surgery, excluding infective endocarditis, between 2010 and 2016.
Among nearly 2 million patients who received the surgery over the study period, 5707 had opioid use disorder, researchers reported. Patients with opioid use disorder tended to be younger (an average 54 years, compared with 66 years for cardiac surgery patients without opioid use disorder), to earn less (33.6% were in the lowest income quartile, compared with 27.1% without opioid use disorder), and to be insured by Medicaid (28.2%, compared with 6.2% of those without the disorder).
“Although the presence of OUD was not associated with excess mortality at index hospitalization, it was predictive of 30-day readmission,” researchers wrote.
The 30-day readmission rate was 19% among patients with opioid use disorder, according to the study, compared with 13.2% for patients without opioid use disorder. Rates of thromboembolic and infectious events were also higher in patients with opioid use disorder (1.3% and 4.1%, respectively), compared with patients without opioid use disorder (0.8% and 2.8%, respectively).
“Increased attention to predischarge interventions and care coordination may improve outcomes in this population,” researchers concluded.
Madrigal J, Sanaiha Y, Hadaya J, Dhawan P, Benharash P. Impact of opioid use disorders on outcomes and readmission following cardiac operations [published online ahead of print, 2020 Oct 29]. Heart. 2020;heartjnl-2020-317618. doi:10.1136/heartjnl-2020-317618