Higher mortality risk in post-surgery opioid use

Patients who were prescribed opioids following surgery have higher risks of hospital readmission and mortality, according to a study by the University of Hong Kong's medical school.

The Centers for Disease Control and Prevention in the United States has issued clinical practice guidelines for the prescription of opioid analgesics for patients with moderate to severe postoperative pain that suggested the use of opioid medications at the time of discharge may increase the risk of readmission and death.

An analysis conducted by the university using Hospital Authority records from 2000 to 2020, involving a total of 438,128 patients, found that of all patients who underwent surgery, 32,932 were prescribed opioids and 405,196 were not.

Those prescribed opioids had a 12.6 percent visitation rate to the emergency department, or four percentage points higher.

The mortality rate was 0.6 percentage points higher.

The use of opioids can also lead to patient dependency and prolonged opioid use.

Carlos Wong King-ho, honorary assistant professor of pharmacology and pharmacy, said the findings highlight the impact of opioid medications on pain management after a patient is discharged.

The use of opioids increases the likelihood of utilizing medical services and worsens clinical outcomes, emphasizing the need to improve use of opioid medications.

Despite the adverse effects of opioid medications, Brian Lang Hung-hin, Li Shu Fan Medical Foundation professor in surgery, said they can still be an option for postoperative pain management.

"To mitigate the risk of developing opioid dependence or addiction, patients may consider alternative pain management strategies such as non-opioid pain relief medications, physical and cognitive-behavioral therapy, as well as discussing with doctors to collaboratively develop a plan that weighs the benefits of pain relief against the associated risks before resorting to opioid use," he said.