Journal article
Predonation Prescription Opioid Use: A Novel Risk Factor for Readmission After Living Kidney Donation
American journal of transplantation, Vol.17(3), pp.744-753
03/01/2017
DOI: 10.1111/ajt.14033
PMID: 27589826
Abstract
Implications of opioid use in living kidney donors for key outcomes, including readmission rates after nephrectomy, are unknown. We integrated Scientific Registry of Transplant Recipients data with records from a nationwide pharmacy claims warehouse and administrative records from an academic hospital consortium to quantify predonation prescription opioid use and postdonation readmission events. Associations of predonation opioid use (adjusted odds ratio [ aOR]) in the year before donation and other baseline clinical, procedural, and center factors with readmission within 90 days postdonation were examined by using multivariate logistic regression. Among 14 959 living donors, 11.3% filled one or more opioid prescriptions in the year before donation. Donors with the highest level of predonation opioid use (>305 mg/year) were more than twice as likely as nonusers to be readmitted (6.8% vs. 2.6%; aOR 2.49, 95% confidence interval 1.74-3.58). Adjusted readmission risk was also significantly (p < 0.05) higher for women (aOR = 1.25), African Americans (aOR = 1.45), spouses (aOR = 1.42), exchange participants (aOR = 1.46), uninsured donors (aOR = 1.40), donors with predonation estimated glomerular filtration rate <60 mL/min/1.73 m(2) (aOR = 2.68), donors with predonation pulmonary conditions (aOR = 1.54), and after robotic nephrectomy (aOR = 1.68). Predonation opioid use is independently associated with readmission after donor nephrectomy. Future research should examine underlying mechanisms and approaches to reducing risks of postdonation complications.
Details
- Title: Subtitle
- Predonation Prescription Opioid Use: A Novel Risk Factor for Readmission After Living Kidney Donation
- Creators
- K. L. Lentine - Saint Louis UniversityN. N. Lam - University of AlbertaM. A. Schnitzler - Saint Louis UniversityG. P. Hess - Leonard Davis Institute of Health EconomicsB. L. Kasiske - Hennepin County Medical CenterH. Xiao - Saint Louis UniversityD. Axelrod - East Carolina UniversityA. X. Garg - Western UniversityJ. D. Schold - Department of Quantitative Health Sciences; Cleveland Clinic; Cleveland OHH. Randall - Saint Louis UniversityN. Dzebisashvili - Carolinas Healthcare SystemD. C. Brennan - Washington University in St. LouisD. L. Segev - Johns Hopkins University
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.17(3), pp.744-753
- DOI
- 10.1111/ajt.14033
- PMID
- 27589826
- NLM abbreviation
- Am J Transplant
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Publisher
- Wiley
- Number of pages
- 10
- Grant note
- KRESCENT New Investigator Award; Canadian Institutes of Health Research (CIHR) Dr. Adam Linton Chair in Kidney Health Analytics R01-DK096008; K24-DK101828 / National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) U.S. government HHSH250201000018C / Minneapolis Medical Research Foundation (MMRF)
- Language
- English
- Date published
- 03/01/2017
- Academic Unit
- Surgery
- Record Identifier
- 9984322790902771
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