• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Predictors of Opioid Related Adverse Events in Open and Laparoscopic Colorectal Surgery

Deborah S Keller, MS, MD1, David R Flum, MD, MPH, FACS2, Eric M Haas, MD, FACS, FASCRS3. 1Colorectal Surgical Associates, 2University of Washington, 3Colorectal Surgical Associates; Houston Methodist Hospital; University of Texas Medical Center at Houston

Background: Opioids remain a mainstay of postsurgical pain control despite the potential impact of opioid related adverse events (ORAEs) on patient outcomes and resource utilization. Our goal was to evaluate the incidence, predictors, and impact of ORAE in patients who underwent colorectal surgery.

Methods: The Premier Perspective national inpatient database was reviewed for patients undergoing a colorectal resection from 7/2013-11/2014. Patients were stratified into laparoscopic or open cohorts. The outcome measures were the incidence of ORAE (identified by ICD-9 diagnosis codes), opioid consumption (identified from charges), total hospital costs (estimated from cost to charge ratios), and resource utilization in patients with/without an ORAE. Multivariate logistic regression was used to evaluate factors associated with ORAEs in open and laparoscopic colorectal surgery.

Results: 35,008 patients were evaluated- 18,779 open and 16,229 laparoscopic. Median opioid consumption was 446 mg (inter-quartile range, 217.5-900) in the open group and 272 mg (inter-quartile range, 126-611) in the laparoscopic group. 26.2% of open and 24.7% of laparoscopic patients had a patient controlled analgesia for pain control. Rates of ORAE were 19.8% and 17.6% in the open and laparoscopic cohorts, respectively. The most common ORAE was ileus (10.9% open, 10.1% laparoscopic). The regression model found patients consuming >300mg of opiates, age >65, males, comorbidities of primary malignancy and chronic obstructive pulmonary disease, and undergoing abdominoperineal resection were associated with higher likelihood of ORAE in both open and laparoscopic cohorts. In the open procedure group, additional predictors included presence of congestive heart failure, obesity, chronic pain, and urgent/emergent cases. In the laparoscopic group, additional predictors included chronic renal failure and a total abdominal colectomy. On an unadjusted basis, patients who experienced an ORAE had significantly longer length of stay (9.8 vs. 10.8 days, p<0.01 open; 5.4 vs. 8.2 days, p<0.01 laparoscopic), higher mortality (2.9% vs. 3.9%, p<0.01 open; 0.31% vs. 1.2%, p<0.01 laparoscopic), and higher hospitalization costs ($21,459 vs. $24,712, p<0.01 open; $14,928 vs. $20,318, p<0.01 laparoscopic).  

Conclusions: Currently, nearly 20% of patients undergoing open and laparoscopic colorectal surgery experience an ORAE. ORAEs carry a significant clinical and financial burden, potentially increasing length of stay, costs, and mortality rate. This study found level of opiate consumption, age, gender, and comorbidities to be predictive of an ORAE. With ORAE incidence and predictors identified, preemptive measures can be taken to improve postoperative recovery and resource utilization.

344

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2016 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons