Opioid prescriptions continue to carry significant short- and long-term systemic risks, even after ophthalmic surgery. The goal of this study was to identify any association of opioid prescription, after ophthalmic surgery, with postoperative hospitalization, opioid overdose, opioid dependence, and all-cause mortality. Retrospective, cross-sectional analysis. Patients undergoing an ophthalmic surgery in the OptumLabs Data Warehouse. We used deidentified administrative claims data from the OptumLabs Data Warehouse to create 3 cohorts of patients for analysis from January 1, 2016, to June 30, 2022. The first cohort consisted of 1-to-1 propensity score–matched patients who had undergone ophthalmic surgery and had filled a prescription for an opioid and not filled a prescription for an opioid. The second cohort consisted of patients who were considered opioid naïve and had filled a prescription for an opioid matched to patients who had not filled a prescription for an opioid. The last cohort consisted of opioid-naïve patients matched across the following morphine milligram equivalents (MME) groups: ≤ 40, 41–80, and > 80. Short- and long-term risks of hospitalization, opioid overdose, opioid dependency/abuse, and death were compared between the cohorts. We identified 1 577 692 patients who had undergone an ophthalmic surgery, with 312 580 (20%) filling an opioid prescription. Among all patients, filling an opioid prescription after an ophthalmic surgery was associated with increased mortality (hazard rate [HR], 1.28; 95% confidence interval [CI], 1.25–1.31; < 0.001), hospitalization (HR, 1.51; 95% CI, 1.49–1.53; < 0.001), opioid overdose (HR, 7.31; 95% CI, 6.20–8.61, < 0.001), and opioid dependency (HR, 13.05; 95% CI, 11.48–14.84; < 0.001) compared with no opioid prescription. Furthermore, we found that higher MME doses of opioids were associated with higher rates of mortality, hospitalization, and abuse/dependence. Patients who filled an opioid prescription after an ophthalmic surgery experienced higher rates of mortality, hospitalization, episodes of opioid overdose, and opioid dependence compared with patients who did not fill an opioid prescription. Proprietary or commercial disclosure may be found after the references.

中文翻译：

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与眼科手术相关的阿片类药物处方后的住院、用药过量和死亡率

即使在眼科手术后，阿片类药物处方仍会带来重大的短期和长期系统性风险。本研究的目的是确定眼科手术后阿片类药物处方与术后住院、阿片类药物过量、阿片类药物依赖和全因死亡率之间的关联。回顾性、横断面分析。在 OptumLabs 数据仓库中接受眼科手术的患者。我们使用来自 OptumLabs 数据仓库的去识别化行政索赔数据创建了 3 个患者队列，用于从 2016 年 1 月 1 日到 2022 年 6 月 30 日进行分析。第一个队列由 1 对 1 倾向评分匹配的接受过眼科检查的患者组成。手术并已开具阿片类药物处方，且未开具阿片类药物处方。第二组由被认为未使用阿片类药物且已开具阿片类药物处方的患者与未开具阿片类药物处方的患者组成。最后一个队列由未使用阿片类药物的患者组成，匹配以下吗啡毫克当量 (MME) 组：≤ 40、41-80 和 > 80。住院、阿片类药物过量、阿片类药物依赖/滥用、比较各队列之间的死亡率和死亡率。我们确定了 1 577 692 名接受过眼科手术的患者，其中 312 580 名 (20%) 服用了阿片类药物处方。在所有患者中，眼科手术后服用阿片类药物处方与死亡率（风险率 [HR]，1.28；95% 置信区间 [CI]，1.25–1.31；< 0.001）、住院率（HR，1.51；95%）增加相关。 CI，1.49-1.53​​；< 0.001）、阿片类药物过量（HR，7.31；95% CI，6.20-8.61，< 0.001）和阿片类药物依赖（HR，13.05；95% CI，11.48-14.84；< 0.001）没有阿片类药物处方。此外，我们发现较高的阿片类药物 MME 剂量与较高的死亡率、住院率和滥用/依赖性相关。与未开具阿片类药物处方的患者相比，在眼科手术后开具阿片类药物处方的患者死亡率、住院率、阿片类药物过量发作率和阿片类药物依赖率更高。专有或商业披露可以在参考文献之后找到。