Association of Opioid-Related Adverse Drug Events With Clinical and Cost Outcomes Among Surgical Patients in a Large Integrated Health Care Delivery System.

摘要: Importance Opioids are commonly used for pain control during and after invasive procedures. However, opioid-related adverse drug events (ORADEs) common have been associated with worse patient outcomes. Objectives To examine the incidence of ORADEs in patients undergoing hospital-based surgical endoscopic procedures to evaluate association clinical cost Design, Setting, Participants In this retrospective study administrative data, were identified using International Classification Diseases , Ninth Revision diagnosis codes known effects opioids or by opioid antagonist use. Multivariable regression analysis was measure outcomes adjusting potential confounding factors. The setting 21 acute care hospitals a large integrated health delivery system. 135 379 (aged ≥18 years, admitted from January 1, 2013, September 30, 2015) who underwent given opioids. Exposure Opioid use, reported as morphine milligram equivalent doses. Main Outcomes Measures Opioid-related their inpatient mortality, discharge another facility, length stay, hospitalization, 30-day readmission. Results Among adult (67.5% female), 14 386 (10.6%) experienced at least one ORADE. Patients more likely be older, white race/ethnicity, male comorbidities. received higher total dose (median dose, 46.8 vs 30.0 mg; P Conclusions Relevance among significantly Hospital-acquired harm population is an important opportunity systems improve safety reduce cost.