Post-surgical opioid prescribing patterns and risk factors for additional opioid prescriptions within one year after non-emergent colorectal surgery

Abstract

Background: National opioid concerns resulted in review of prescribing patterns following colorectal surgery.

Methods: This retrospective cohort study examined prescribing patterns in elective colorectal surgery at a tertiary academic medical center from January 2012 through December 2014.

Results: Forty percent of 4286 patients received additional opioid prescriptions within the year following colorectal surgery. Multivariable analysis demonstrated that a pre-operative opioid prescriptions within 1 year of surgery (OR 2.91; 95% CI, 1.83-4.60), increasing operative time (OR 1.02; 95% CI, 1.00-1.04), or complications (OR 2.18; 95% CI, 1.38-3.43) was associated with additional opioid prescriptions. The median opioid prescription upon discharge was 225 mg morphine milligram equivalents. Discharge opioid amount was not a risk factor.

Conclusions: Additional opioid prescriptions after surgery occurred in 40% of patients. Pre-operative prescriptions, increasing operative time and complications were associated with additional opioid prescriptions while opioid amount at discharge was not a risk factor.