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Surgical Endoscopy
Published in: Surgical Endoscopy 10/2021

01-10-2021 | Antidepressant Drugs

Preoperative opioid, sedative, and antidepressant use is associated with increased postoperative hospital costs in colorectal surgery

Authors: Nicholas A. Jackson, Tong Gan, Daniel L. Davenport, Doug R. Oyler, Laura M. Ebbitt, B. Mark Evers, Avinash S. Bhakta

Published in: Surgical Endoscopy | Issue 10/2021

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Abstract

Background

Opioid (OPD), sedative (SDT), and antidepressant (ADM) prescribing has increased dramatically over the last 20 years. This study evaluated preoperative OPD, SDT, and ADM use on hospital costs in patients undergoing colorectal resection at a single institution.

Methods

This study was a retrospective record review. The local ACS-NSQIP database was queried for adult patients (age ≥ 18 years) undergoing open/laparoscopic, partial/total colectomy, or proctectomy from January 1, 2013 to December 31, 2016. Individual patient medical records were reviewed to determine preoperative OPD, SDT, and AD use. Hospital cost data from index admission were captured by the hospital cost accounting system and matched to NSQIP query-identified cases. All ACS-NSQIP categorical patient characteristic, operative risk, and outcome variables were compared in medication groups using chi-square tests or Fisher’s exact tests, and continuous variables were compared using Mann–Whitney U tests.

Results

A total of 1185 colorectal procedures were performed by 30 different surgeons. Of these, 27.6% patients took OPD, 18.5% SDT, and 27.8% ADM preoperatively. Patients taking OPD, SDT, and ADM were found to have increased mean total hospital costs (MTHC) compared to non-users (30.8 vs 23.6 for OPD, 31.6 vs 24.4 for SDT, and 30.7 vs 23.8 for ADM). OPD and SDT use were identified as independent risk factors for increased MTHC on multivariable analysis.

Conclusion

Preoperative OPD and SDT use can be used to predict increased MTHC in patients undergoing colorectal resections.
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Metadata
Title
Preoperative opioid, sedative, and antidepressant use is associated with increased postoperative hospital costs in colorectal surgery
Authors
Nicholas A. Jackson
Tong Gan
Daniel L. Davenport
Doug R. Oyler
Laura M. Ebbitt
B. Mark Evers
Avinash S. Bhakta
Publication date
01-10-2021
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 10/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-020-08062-w

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