Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery

• Published in: Journal of pain research 2018-01, Vol.11, p.1017-1025
• Main Authors: Wittbrodt, Eric T, Gan, Tong J, Datto, Catherine, McLeskey, Charles, Sinha, Meenal
• Format: Article
• Language: English
• Subjects: Alvimopan; Ambulatory care facilities; Analgesics; Analysis; Bone surgery; CFR; Codes; Comorbidity; Constipation; Diabetes; Economic aspects; Gastrointestinal surgery; Health care costs; Health care expenditures; Health care policy; Health services utilization; healthcare resource utilization; Hip replacement arthroplasty; Hospital costs; Hospital patients; Hospitalization; Joint replacement surgery; Knee and hip replacement surgery; Knee replacement arthroplasty; Laxatives; Levorphanol; Linaclotide; Liver diseases; Lubiprostone; Medical care utilization; Methylnaltrexone; Naloxegol; Narcotics; Opioid-induced constipation; Opioids; Original Research; Pain management; Patient satisfaction; Strategic planning (Business); Surgery; Tapentadol
• ISSN: 1178-7090; 1178-7090
• DOI: 10.2147/JPR.S160045

Constipation is a well-known complication of surgery that can be exacerbated by opioid analgesics. This study evaluated resource utilization and costs associated with opioid-induced constipation (OIC). This retrospective, observational, and propensity-matched cohort study utilized the Premier Healthcare Database. The study included adults ≥18 years of age undergoing total hip or total knee replacement as inpatients who received an opioid analgesic and were discharged between January 1, 2012, and June 30, 2015. Diagnosis codes identified patients with OIC who were then matched 1:1 to patients without OIC. Generalized linear and logistic regression models were used to compare inpatient resource utilization, total hospital costs, inpatient mortality, and 30-day all-cause readmissions and emergency department visits. Of 788,448 eligible patients, 40,891 (5.2%) had OIC. Covariates were well balanced between matched patients with and without OIC (n=40,890 each). In adjusted analyses, patients with OIC had longer hospital lengths of stay (3.6 versus 3.3 days;