The Incidence of New Persistent Opioid Use Following Cardiac Surgery via Sternotomy.

Abstract Background In recent years, increased attention has turned towards the risk of chronic opioid usage following surgery. In this nationwide cohort study, we examined the rate of new persistent opioid use following cardiac surgery via sternotomy. Methods All opioid-naive patients undergoing heart surgery via sternotomy from 2005 to 2018 in Iceland, were included in the study. Naivety was defined as not filling an opioid prescription within six months preoperatively. Persistent opioid use was defined as filling of at least one opioid prescription during the first 90 days after surgery and another between 90-180 days after the operation. In addition to estimating the incidence of new persistent opioid use, differences in patient characteristics, survival and readmission rates were compared between the group with and without new persistent opioid use. Results Of 1,227 patients that underwent cardiac surgery via sternotomy during the study period, 925 were included in the study. Of those, 4.6% developed new persistent opioid use. When only patients who filled an opioid prescription postoperatively were included, 10.1% developed new persistent opioid use. Chronic obstructive pulmonary disease, preoperative usage of NSAIDs, gabapentinoids, and nitrates were associated with increased risk of new persistent opioid use. Patients with new persistent opioid use had neither higher rates of readmission nor all-cause mortality. Conclusions The rate of new persistent opioid use following cardiac surgery was 4.6%. Future steps should identify strategies to minimize the development of new persistent opioid use.