Opioid-Related Adverse Drug Events in Surgical Hospitalizations: Impact on Costs and Length of Stay
Top Cited Papers
- 1 March 2007
- journal article
- research article
- Published by SAGE Publications in Annals of Pharmacotherapy
- Vol. 41 (3), 400-407
- https://doi.org/10.1345/aph.1h386
Abstract
Opioid analgesics remain a mainstay in the treatment of pain associated with surgical procedures. Such use is associated with adverse drug events (ADEs). To investigate the impact of opioid-related ADEs on total hospital costs and length of stay (LOS) in adult surgical patients. This was a retrospective matched cohort study using data from computerized medical records. ADE cases were prospectively detected using computerized surveillance and verified by pharmacists. Surgical patients treated at LDS Hospital in Salt Lake City from January 1, 1998, to December 31, 2003, were included. The primary outcomes were costs and hospital LOS associated with opioid-related ADEs and the relationship of opioid dose to ADE events. Patients experiencing opioid-related ADEs had significantly increased median total hospital costs (7.4% increase; 95% CI 3.83 to 10.96; p < 0.001) and increased median LOS (10.3% increase; 95% CI 6.5 to 14.2; p < 0.001) compared with matched non-ADE contrals. The increased costs attributable to ADEs, by surgery type, were general surgery ($676.51; 95% CI 351.50 to 1001.50), orthopedics ($861.50; 95% CI 448.20 to 1274.80), and obstetrics/gynecology ($540.90; 95% CI 281.40 to 800.40). Similarly, increased LOS attributable to ADEs, by surgery type, were general surgery (0.64 days; 95% CI 0.40 to 0.88), orthopedics (0.52 days; 95% CI 0.33 to 0.71), and obstetrics/gynecology (0.53 days; 95% CI 0.33 to 0.72). Higher doses of opioids were associated with increased risk of experiencing ADEs (OR 1.3; 95% CI 1.07 to 1.60; p = 0.01). Opioid-related ADEs following surgery were associated with significantly increased LOS and hospitalization costs. These ADEs occurred more frequently in patients receiving higher doses of opioids.Keywords
This publication has 9 references indexed in Scilit:
- Comparison of Morphine, Ketorolac, and Their Combination for Postoperative PainAnesthesiology, 2005
- Cost of Opioid-Related Adverse Drug Events in Surgical PatientsJournal of Pain and Symptom Management, 2003
- Sample Size Calculations for Cluster Randomised TrialsJournal of Health Services Research & Policy, 2000
- The Costs of Adverse Drug Events in Hospitalized PatientsJAMA, 1997
- Computerized Surveillance of Adverse Drug Events in Hospital PatientsJAMA, 1991
- The HELP systemJournal of Medical Systems, 1983
- A method for estimating the probability of adverse drug reactionsClinical Pharmacology & Therapeutics, 1981
- The Interpretation and Estimation of Cobb-Douglas FunctionsEconometrica, 1968