Association Between Opioid Use and Readmission Following Liver Transplantation

Published in: Clinical Transplantation, 2016

Posted on RAND.org on July 25, 2016

by Shari Rogal, Gautham Mankaney, Viyan Udawatta, Chester B. Good, Matthew Chinman, Susan L. Zickmund, Klaus Bielefeldt, Naudia Jonassaint, Alison Jazwinski, Obaid Shaikh, Christopher Hughes, Abhinav Humar, Andrea DiMartini, Michael J. Fine

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Prescription opioid use has been associated with readmission following liver transplantation, although little is known for the reasons of this association. Our study aim was to assess the independent association between pre-transplant prescription opioid use and readmission following liver transplantation. We reviewed medical record of all patients at a single medical center undergoing primary, single-organ, liver transplantation from 2004–2014. We assessed factors associated with hospital readmission 30-days and 1-year after hospital discharge using multivariable Cox proportional-hazards models. Among 1,056 transplant recipients, 49 (4.6%) used pre-transplant prescription opioids. Readmission occurred in 421 (40%) patients within 30-days and 689 (65%) within 1-year. Patients with pre-transplant opioid use had significantly higher risk of readmission at 30-days (HR 1.7; 95% CI 1.1-2.5), and a non-significantly elevated risk at 1-year (HR 1.4; 95% CI 1.0-1.9) when controlling for other potential confounders. Although pain was the major reason for readmission in only 12 (3%) patients at 30-days and 33 (6%) patients at 1-year, pre-transplant opioid use was significantly associated with pain-related readmissions at both time points. In conclusion, prescription opioid use pre-transplantation was relatively uncommon, prior use was significantly associated with all-cause 30-day readmission and pain-related readmissions at 30-days and 1-year.

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