Background

The epidemiology of persistent postoperative opioid use at least 3 months after cardiac surgery is poorly characterised despite its potential public health importance.

Methods

We searched MEDLINE, Embase, and Google Scholar from inception to December 2021 and included studies reporting the rate and risk factors of persistent postoperative opioid use after cardiac surgery in opioid-naive and opioid-exposed patients. We recorded incidence rates and odds ratios (ORs) with 95% confidence intervals (CIs) for risk factors from individual studies and used random-effects inverse variance modelling to generate pooled estimates.

Results

From 10 studies involving 112 298 patients, the pooled rate of persistent postoperative opioid use in opioid-naive patients was 5.7% (95% CI: 4.2–7.2%). Risk factors included female sex (OR 1.18; 95% CI: 1.09–1.29), smoking (OR 1.34; 95% CI: 1.06–1.69), alcohol use (OR 1.43; 95% CI: 1.17–1.76), congestive cardiac failure (OR 1.17; 95% CI: 1.08–1.27), diabetes mellitus (OR 1.21; 95% CI: 1.07–1.37), chronic lung disease (OR 1.42; 95% CI: 1.16–1.75), chronic kidney disease (OR 1.35; 95% CI: 1.08–1.68), and length of hospital stay (per day) (OR 1.03; 95% CI: 1.02–1.04).

Conclusions

Persistent postoperative opioid use after cardiac surgery affects at least one in 20 patients. The identification of risk factors, such as female sex, smoking, alcohol use, congestive cardiac failure, diabetes mellitus, chronic lung disease, chronic kidney disease, and length of hospital stay, should help target interventions aimed at decreasing its prevalence.

中文翻译：

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心脏手术后持续使用阿片类药物的流行病学：系统评价和荟萃分析

背景

尽管其潜在的公共卫生重要性，但在心脏手术后至少 3 个月持续使用阿片类药物的流行病学特征尚不明确。

方法

我们检索了 MEDLINE、Embase 和 Google Scholar 从开始到 2021 年 12 月的时间，并纳入了报告在初次使用阿片类药物和暴露于阿片类药物的患者中心脏手术后持续使用阿片类药物的比率和风险因素的研究。我们记录了各个研究中风险因素的发生率和优势比 (OR) 以及 95% 置信区间 (CI)，并使用随机效应逆方差模型生成汇总估计值。

结果

在涉及 112 298 名患者的 10 项研究中，未使用阿片类药物的患者术后持续使用阿片类药物的汇总率为 5.7%（95% CI：4.2-7.2%）。危险因素包括女性（OR 1.18；95% CI：1.09-1.29）、吸烟（OR 1.34；95% CI：1.06-1.69）、饮酒（OR 1.43；95% CI：1.17-1.76）、充血性心力衰竭（OR 1.17；95% CI：1.08-1.27）、糖尿病（OR 1.21；95% CI：1.07-1.37）、慢性肺病（OR 1.42；95% CI：1.16-1.75）、慢性肾病（OR 1.35） ; 95% CI: 1.08–1.68) 和住院天数 (OR 1.03; 95% CI: 1.02–1.04)。

结论

心脏手术后持续使用阿片类药物会影响至少 20 名患者中的一名。确定风险因素，如女性、吸烟、饮酒、充血性心力衰竭、糖尿病、慢性肺病、慢性肾病和住院时间，应有助于制定旨在降低其患病率的干预措施。