Journal article
Opioid Risk Tool Scores are Not Associated With Opioid Misuse After Elective General Surgery: A Prospective Study
The Journal of surgical research, Vol.326, pp.159-166
07/08/2026
DOI: 10.1016/j.jss.2026.06.036
PMID: 42419063
Abstract
Assessment for opioid misuse is not widely utilized preoperatively. Yet, it can offer valuable clinical insight for patient counseling. The opioid risk tool (ORT) and its opioid use disorder-specific variant (ORT-OUD) predict opioid misuse in chronic pain patients. Although recommended for surgical patients, neither has been validated. Herein, we sought to validate the ORT and ORT-OUD in patients undergoing elective general surgery procedures.
This was a prospective observational study. Consented patients filled out the ORT. Demographics, prescribed opioids, and adjuncts were collected. Pain control ratings after surgery and whether patients were still using opioids were collected at 30 days post surgery. Patients were grouped as low, medium, and high-risk for opioid misuse based on ORT or ORT-OUD scores and compared. P < 0.05 was considered significant.
We included 178 patients; 139, 28, and 11 scored low, medium, and high-risk on the ORT, respectively. Compared to low-risk, medium-risk and high-risk patients were more likely to call for pain (8% versus 32.1% versus 36.4%; P < 0.001) and rate their pain control as poor or fair (8.5% versus 25% versus 18.2%; P = 0.047). Only three opioid-naïve patients were still using opioids 30 days post surgery; they all scored low-risk on ORT. Similar results were obtained with the ORT-OUD.
Although higher ORT scores are associated with worse pain satisfaction and an increased likelihood of a phone call for pain, the ORT and ORT-OUD were not validated as predictive tools for prolonged opioid use or opioid misuse following elective general surgery.
Details
- Title: Subtitle
- Opioid Risk Tool Scores are Not Associated With Opioid Misuse After Elective General Surgery: A Prospective Study
- Creators
- Lauren Hasan - University of Iowa Health CareTristan Milarch - University of IowaNicholas J Rudzianski - University of IowaCheryl M Byrnes - University of IowaColette Galet - University of IowaDionne A Skeete - University of IowaRyan Carnahan - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of surgical research, Vol.326, pp.159-166
- DOI
- 10.1016/j.jss.2026.06.036
- PMID
- 42419063
- NLM abbreviation
- J Surg Res
- ISSN
- 1095-8673
- eISSN
- 1095-8673
- Publisher
- Elsevier
- Grant note
- National Center for Advancing Translational Sciences of the National Institutes of Health: UM1TR004403 Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS): U1QHP28731
Research reported in this publication was partially supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UM1TR004403. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The work reported in this publication was also partially supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under grant number U1QHP28731, Iowa Geriatrics Workforce Enhancement Program for $3,753,682. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by, HRSA, HHS, or the US Government.
- Language
- English
- Date published
- 07/08/2026
- Academic Unit
- Epidemiology; Surgery; Nursing; Injury Prevention Research Center; University of Iowa Health Care
- Record Identifier
- 9985180877502771
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