Variation in opioid-free discharge after metabolic surgery from 2018 to 2023: a state-wide analysis from the Michigan Bariatric Surgery Collaborative
Recommended Citation
Crumbley M, Petersen S, Bonham AJ, Yang P, Gururaj A, Deng C, Dennis A, Carlin AM, and Varban OA. Variation in opioid-free discharge after metabolic surgery from 2018 to 2023: a state-wide analysis from the Michigan Bariatric Surgery Collaborative. Surg Obes Relat Dis 2025.
Document Type
Article
Publication Date
6-1-2025
Publication Title
Surg Obes Relat Dis
Abstract
BACKGROUND: Efforts have been made to reduce opioid prescribing after metabolic-bariatric surgery (MBS) given the increased risk for misuse. Variation in prevalence of opioid-free discharge following MBS and its impact on outcomes remains unclear.
OBJECTIVES: To evaluate variation in opioid prescribing practices after MBS and the impact of opioid-free discharge on outcomes.
SETTING: MBS programs participating in a state-wide quality improvement collaborative.
METHODS: Using a state-wide bariatric-specific data registry, all patients who underwent MBS between 2018 and 2023 and had opioid prescribing data were identified (n = 54,276). Patient characteristics and 30-day risk-adjusted outcomes were compared between patients who were and were not prescribed opioids at discharge. Surgeon and practice characteristics were also compared between the top and bottom quartiles of opioid-free discharge.
RESULTS: The prevalence of opioid-free discharge increased from 7.7% to 32.1% over the study period. Only .4% of patients, who were opioid-free at discharge, obtained an opioid prescription within 30 days of discharge. Opioid-free discharge was associated with lower rates of emergency department (ED) visits (7.7% vs 8.2%, P = .0008), despite similar complication rates (7.6% vs 7.3%, P = .7261). There were no significant differences in age, case volume, or practice types between surgeons in the top quartile and bottom quartile for opioid-free discharge.
CONCLUSIONS: Opioid-free discharge after MBS has increased in prevalence with extremely low failure rates without negatively impacting ED visit rates. Variation in opioid prescribing persists and may be due to patient-specific factors as well as surgeon-specific preference.
Medical Subject Headings
Humans; Bariatric Surgery; Analgesics, Opioid; Female; Patient Discharge; Male; Middle Aged; Pain, Postoperative; Practice Patterns, Physicians'; Michigan; Adult; Quality Improvement; Drug Prescriptions; Registries
PubMed ID
39948009
ePublication
ePub ahead of print
Volume
21
Issue
6
First Page
619
Last Page
626
