Impact of Preoperative Opioid Use on Health Outcomes Following Bariatric Surgery

Abstract Background Opioid consumption in North America has risen to alarming levels and represents a potentially modifiable risk factor in perioperative management. Chronic pain and obesity are commonly associated and bariatric surgery remains the most effective intervention for weight loss in morbidly obese patients. It is critical to understand how preoperative opioid use impacts surgical outcomes in patients undergoing bariatric surgery. Study Design Data collected in the Ontario Bariatric Registry between 2010–2018 was used for this retrospective study. Preoperative opioid use was retrospectively retrieved from the medication review during preoperative assessment. Primary outcomes were complications and readmissions at 30 and 90 days of surgery. Secondary outcomes included hospital length of stay (LOS) and complication types at 30 and 90 days. Analyses were risk-adjusted for procedure type and patient-specific risk factors such as age, gender, race, body mass index (BMI), and comorbid conditions. Results Overall, 5357 patients were included in the study. Among those, 12% (n=643) used opioids preoperatively. Risk-adjusted analyses demonstrated that opioid users, compared to opioid-naive patients, had a longer LOS (OR: 2.50, 95% CI:1.05-6.00, p Conclusion Opioid use is common before bariatric surgery and is independently associated with prolonged LOS and complication rates at 30 days. Preoperative opioid use represents a potentially modifiable risk factor and a unique target to improving the quality of surgical care.