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Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery
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 Health...
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| Published in: | Journal of pain research 2018-01, Vol.11, p.1017-1025 |
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| creator | Wittbrodt, Eric T Gan, Tong J Datto, Catherine McLeskey, Charles Sinha, Meenal |
| description | 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; |
| doi_str_mv | 10.2147/JPR.S160045 |
| format | article |
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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;
<0.001), higher total hospital costs (US$17,479 versus US$16,265;
<0.001), greater risk of intensive care unit admission (odds ratio [OR]=1.12, 95% CI: 1.01-1.24), and increased likelihood of 30-day hospital read-missions (OR=1.16, 95% CI: 1.11-1.22) and emergency department visits (OR=1.38, 95% CI: 1.07-1.79) than patients without OIC. No statistically significant difference was found with inpatient mortality (OR=0.89, 95% CI: 0.59-1.35).
OIC was associated with greater resource utilization and hospital costs for patients undergoing primarily elective total hip or total knee replacement surgery. These results support OIC screening and management strategies as part of perioperative care management.</description><identifier>ISSN: 1178-7090</identifier><identifier>EISSN: 1178-7090</identifier><identifier>DOI: 10.2147/JPR.S160045</identifier><identifier>PMID: 29881304</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>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</subject><ispartof>Journal of pain research, 2018-01, Vol.11, p.1017-1025</ispartof><rights>COPYRIGHT 2018 Dove Medical Press Limited</rights><rights>2018. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Wittbrodt et al. This work is published and licensed by Dove Medical Press Limited 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-9aac590b1e75d54cb1d7ab64c961844e42b348da464479b71d584a82f75e782c3</citedby><orcidid>0000-0002-4132-5851 ; 0000-0002-4060-7638</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2237630258/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2237630258?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29881304$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wittbrodt, Eric T</creatorcontrib><creatorcontrib>Gan, Tong J</creatorcontrib><creatorcontrib>Datto, Catherine</creatorcontrib><creatorcontrib>McLeskey, Charles</creatorcontrib><creatorcontrib>Sinha, Meenal</creatorcontrib><title>Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery</title><title>Journal of pain research</title><addtitle>J Pain Res</addtitle><description>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;
<0.001), higher total hospital costs (US$17,479 versus US$16,265;
<0.001), greater risk of intensive care unit admission (odds ratio [OR]=1.12, 95% CI: 1.01-1.24), and increased likelihood of 30-day hospital read-missions (OR=1.16, 95% CI: 1.11-1.22) and emergency department visits (OR=1.38, 95% CI: 1.07-1.79) than patients without OIC. No statistically significant difference was found with inpatient mortality (OR=0.89, 95% CI: 0.59-1.35).
OIC was associated with greater resource utilization and hospital costs for patients undergoing primarily elective total hip or total knee replacement surgery. These results support OIC screening and management strategies as part of perioperative care management.</description><subject>Alvimopan</subject><subject>Ambulatory care facilities</subject><subject>Analgesics</subject><subject>Analysis</subject><subject>Bone surgery</subject><subject>CFR</subject><subject>Codes</subject><subject>Comorbidity</subject><subject>Constipation</subject><subject>Diabetes</subject><subject>Economic aspects</subject><subject>Gastrointestinal surgery</subject><subject>Health care costs</subject><subject>Health care expenditures</subject><subject>Health care policy</subject><subject>Health services utilization</subject><subject>healthcare resource utilization</subject><subject>Hip replacement arthroplasty</subject><subject>Hospital costs</subject><subject>Hospital patients</subject><subject>Hospitalization</subject><subject>Joint replacement surgery</subject><subject>Knee and hip replacement surgery</subject><subject>Knee replacement arthroplasty</subject><subject>Laxatives</subject><subject>Levorphanol</subject><subject>Linaclotide</subject><subject>Liver diseases</subject><subject>Lubiprostone</subject><subject>Medical care utilization</subject><subject>Methylnaltrexone</subject><subject>Naloxegol</subject><subject>Narcotics</subject><subject>Opioid-induced constipation</subject><subject>Opioids</subject><subject>Original Research</subject><subject>Pain management</subject><subject>Patient satisfaction</subject><subject>Strategic planning (Business)</subject><subject>Surgery</subject><subject>Tapentadol</subject><issn>1178-7090</issn><issn>1178-7090</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptkl1vFCEUhidGY2v1yntDYmJMzK7AwMDcmDSNHzVNNFWvCcOc2aWyMAXG2n8v46511wgXwOE5L5yPqnpK8JISJl5__Hy5_EIajBm_Vx0TIuRC4Bbf39sfVY9SusK4kbQlD6sj2kpJasyOq5-XkMIUDaApAdK-RyaknJBOKRirM_ToxuY1CqMNtl9Y308GZsinbEedbfBoCM6FG-tXKIesHVrbEYW4O3z3ACjC6LSBDfiM0hRXEG8fVw8G7RI82a0n1bd3b7-efVhcfHp_fnZ6sTAc13nRam14izsCgvecmY70QncNM21DJGPAaFcz2WvWMCbaTpCeS6YlHQQHIampT6rzrW4f9JUao93oeKuCtuq3IcSV0jFb40DhjtUaD5oaVoYcOiPZAK1sByYE56JovdlqjVO3gd6UcKJ2B6KHN96u1Sr8ULwVsvywCLzcCcRwPUHKamOTAee0hzAlRTGnkuC6ntHn_6BXpU6-pEpRWoumxpTLv9RKlwCsH0J518yi6rRcU04Fnqnlf6gye9jYUkoYbLEfOLzYc1iDdnmdgpvmcqdD8NUWNDGkFGG4SwbBau5OVbpT7bqz0M_283fH_mnH-hdrAd9B</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Wittbrodt, Eric T</creator><creator>Gan, Tong J</creator><creator>Datto, Catherine</creator><creator>McLeskey, Charles</creator><creator>Sinha, Meenal</creator><general>Dove Medical Press Limited</general><general>Taylor & Francis Ltd</general><general>Dove Medical Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7XB</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-4132-5851</orcidid><orcidid>https://orcid.org/0000-0002-4060-7638</orcidid></search><sort><creationdate>20180101</creationdate><title>Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery</title><author>Wittbrodt, Eric T ; Gan, Tong J ; Datto, Catherine ; McLeskey, Charles ; Sinha, Meenal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-9aac590b1e75d54cb1d7ab64c961844e42b348da464479b71d584a82f75e782c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Alvimopan</topic><topic>Ambulatory care facilities</topic><topic>Analgesics</topic><topic>Analysis</topic><topic>Bone surgery</topic><topic>CFR</topic><topic>Codes</topic><topic>Comorbidity</topic><topic>Constipation</topic><topic>Diabetes</topic><topic>Economic aspects</topic><topic>Gastrointestinal surgery</topic><topic>Health care costs</topic><topic>Health care expenditures</topic><topic>Health care policy</topic><topic>Health services utilization</topic><topic>healthcare resource utilization</topic><topic>Hip replacement arthroplasty</topic><topic>Hospital costs</topic><topic>Hospital patients</topic><topic>Hospitalization</topic><topic>Joint replacement surgery</topic><topic>Knee and hip replacement surgery</topic><topic>Knee replacement arthroplasty</topic><topic>Laxatives</topic><topic>Levorphanol</topic><topic>Linaclotide</topic><topic>Liver diseases</topic><topic>Lubiprostone</topic><topic>Medical care utilization</topic><topic>Methylnaltrexone</topic><topic>Naloxegol</topic><topic>Narcotics</topic><topic>Opioid-induced constipation</topic><topic>Opioids</topic><topic>Original Research</topic><topic>Pain management</topic><topic>Patient satisfaction</topic><topic>Strategic planning (Business)</topic><topic>Surgery</topic><topic>Tapentadol</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wittbrodt, Eric T</creatorcontrib><creatorcontrib>Gan, Tong J</creatorcontrib><creatorcontrib>Datto, Catherine</creatorcontrib><creatorcontrib>McLeskey, Charles</creatorcontrib><creatorcontrib>Sinha, Meenal</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest_Research Library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of pain research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wittbrodt, Eric T</au><au>Gan, Tong J</au><au>Datto, Catherine</au><au>McLeskey, Charles</au><au>Sinha, Meenal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery</atitle><jtitle>Journal of pain research</jtitle><addtitle>J Pain Res</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>11</volume><spage>1017</spage><epage>1025</epage><pages>1017-1025</pages><issn>1178-7090</issn><eissn>1178-7090</eissn><abstract>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;
<0.001), higher total hospital costs (US$17,479 versus US$16,265;
<0.001), greater risk of intensive care unit admission (odds ratio [OR]=1.12, 95% CI: 1.01-1.24), and increased likelihood of 30-day hospital read-missions (OR=1.16, 95% CI: 1.11-1.22) and emergency department visits (OR=1.38, 95% CI: 1.07-1.79) than patients without OIC. No statistically significant difference was found with inpatient mortality (OR=0.89, 95% CI: 0.59-1.35).
OIC was associated with greater resource utilization and hospital costs for patients undergoing primarily elective total hip or total knee replacement surgery. These results support OIC screening and management strategies as part of perioperative care management.</abstract><cop>New Zealand</cop><pub>Dove Medical Press Limited</pub><pmid>29881304</pmid><doi>10.2147/JPR.S160045</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4132-5851</orcidid><orcidid>https://orcid.org/0000-0002-4060-7638</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Open Access: PubMed Central; Taylor & Francis Open Access; Publicly Available Content (ProQuest) |
| 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 |
| title | Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery |
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