2019 STS: Opioid Use Varies Among Elderly After Lung Resection
Posted: Friday, February 1, 2019
Although opioid dependence among patients older than age 65 after lung resection is high, dependence was significantly lower among those who underwent minimally invasive surgery, according to a Surveillance, Epidemiology, and End Results Program (SEER)-Medicare study presented at the 2019 Society of Thoracic Surgeons (STS) Annual Meeting in San Diego. David B. Nelson, MD, and colleagues, of The University of Texas MD Anderson Cancer Center, Houston, concluded that other independent risk factors include age younger than 70 years, adjuvant therapy, comorbidities, and residence in areas associated with lower education levels.
Using the SEER-Medicare database, the researchers identified almost 7,000 patients who underwent lung resection between 2008 and 2013. Of them, prior to surgery, 57% (n = 3,946) had never used opioids, 29% (n = 2,017) were intermittent opioid users, and 14% (n = 985) were chronic opioid users. The authors defined persistent opioid use as “having a filled opioid prescription [3 to 6] months after lung resection.”
Persistent opioid use was high across the entire patient population (31%). Among patients who were previously opioid-naive, persistent opioid use was also high (17%). Independent predictors of dependence included the receipt of adjuvant radiation or chemotherapy, age younger than 70 years, a Charlson Comorbidity Index of 1 or 2, and residence in zip codes associated with lower education. By contrast, the authors observed lower rates of persistent opioid use among those who underwent minimally invasive surgery.
Disclosure: The study authors’ disclosure information can be found at www.sts.org.