Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study

Importance Vitamin D deficiency is associated with chronic pain syndromes and higher opioid use among cancer patients, but its association with opioid use among opioid-naïve subjects following a major surgical procedure with acute pain has not been explored. Objective To determine the association be...

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Bibliographic Details
Published in:Journal of general internal medicine : JGIM 2020-09, Vol.35 (9), p.2545-2552
Main Authors: Kim, Yuhree, Zhang, Fang, Su, Katherine, LaRochelle, Marc, Callahan, Matthew, Fisher, David, Wharam, J. Frank, Asgari, Maryam M.
Format: Article
Language:English
Subjects:
25-Hydroxyvitamin D
Adolescent
Adult
Analgesics, Opioid - adverse effects
Biomarkers
Chronic pain
Cohort analysis
Cohort Studies
Dosage
Drug addiction
Drug dosages
Humans
Identification methods
Internal Medicine
Medicine
Medicine & Public Health
Middle Aged
Minority & ethnic groups
Morphine
Narcotics
Opioid receptors (type delta)
Opioid-Related Disorders - diagnosis
Opioid-Related Disorders - drug therapy
Opioid-Related Disorders - epidemiology
Original Research
Pain
Regression analysis
Risk Factors
Substance use disorder
Surgery
Vitamin D
Vitamin D - analogs & derivatives
Vitamin deficiency
Young Adult
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Summary:Importance Vitamin D deficiency is associated with chronic pain syndromes and higher opioid use among cancer patients, but its association with opioid use among opioid-naïve subjects following a major surgical procedure with acute pain has not been explored. Objective To determine the association between serum 25-hydroxyvitamin D (25(OH)D) levels, opioid use, and opioid use disorder. Methods We identified commercially insured subjects aged 18–64 years with available perioperative serum 25-hydroxyvitamin D (25D) levels who underwent one of nine major surgical procedures in 2000–2014. Primary outcomes were dose and duration of opioid use measured using pharmacy claims. Secondary outcome was opioid use disorder captured using diagnosis codes. Multivariable negative binomial models with generalized estimating equations were performed examining the association between 25D levels and postoperative opioid use measures, adjusting for age, sex, race/ethnicity, Charlson score, education, income, latitude, and season of blood draw. Adjusted Cox regression was used to examine the association with opioid use disorder. Results Among 5446 subjects, serum 25(OH)D was sufficient (≥ 20 ng/mL) among 4349 (79.9%) subjects, whereas 837 (15.4%) had insufficient (12 to
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-020-06001-y