Perioperative medicine & outcomes
Association of pre‐operative opioid use disorder and postoperative outcomes: a systematic review and meta‐analysis
Pooled result · Incidence of any postoperative pain (primary outcome)Result — go to the resultOdds ratio 2.87 95% CI 1.63–5.06Authors' conclusion
Our results suggest that opioid use disorder is associated with higher incidence of postoperative pain, increased postoperative complications and greater total healthcare costs, which supports the need for routine pre-operative screening for opioid use disorder and the application of patient-centred, multidisciplinary peri-operative care and pain management.
Study context
- Population
- Adults (aged ≥ 18 y) with and without opioid use disorder undergoing surgerystudies reporting postoperative pain three · studies reporting respiratory outcomes 19
- Participants
- 40 included studies
- Comparison
- Adults with and without opioid use disorder undergoing surgery
- Outcome
- Incidence of any postoperative pain (primary outcome)
Pooled result
As reported in the abstract
Odds ratio
2.87
95% CI 1.63–5.06
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Composite adverse respiratory outcomes (primary outcome)Moderate certainty | 2.10 (1.64–2.68) | |
| 0.20.5125Odds ratio (log scale) |
- Composite adverse respiratory outcomes (primary outcome): 19 studies reported respiratory outcomes
Pulmonary embolism, pneumonia and other respiratory and pulmonary complications (subgroup analyses)
- Increased risk with opioid use disorder (low to moderate certainty)
Re-admission rates, duration of hospitalisation and total healthcare costs · 30 and 90 days after surgery (re-admission)
- Higher 30-day and 90-day re-admission rates, prolonged duration of hospitalisation and higher total healthcare costs associated with opioid use disorder (low certainty)
In-hospital mortality
- Did not differ significantly (very low certainty)
Original publication
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