Research published online in the journal Regional Anesthesia & Pain Medicine indicates that the use of opioids for pain relief following lung cancer surgery is associated with a 40% increased risk of death from any cause within the next two years.
The results suggest that there are several characteristics linked to new long-term (6 or more months) use, including male sex, older age, chemotherapy use, anxiety, and insomnia.
With roughly 2.3 million diagnoses and 1.8 million deaths in 2020, lung cancer is a major cause of cancer death worldwide. Additionally, up to 12% of patients have reported experiencing new, persistent postoperative discomfort.
So, the researchers wanted to find out how many of them started using opioids for the first time after surgery, if there were any factors linked to long-term use, and if this was linked to any harmful effects in the next 2 years.
They included all adults in South Korea who had been diagnosed with lung cancer and had surgery for it between 2011 and 2018. This information came from the National Health Insurance Service (NHIS) database.
In order to get payment from the South Korean government, doctors are required to submit information about their patients’ diagnosis, surgeries, and medications. Every registrant’s background personal data, including age, sex, household income, and death date, is also included in the database.
All other opioids, including fentanyl, morphine, oxycodone, hydromorphone, and methadone, were classified as potent opioids; codeine, dihydrocodeine, and tramadol were classified as less potent opioids.
The researchers considered the patient’s age, gender, race/ethnicity, race/ethnicity, kind of surgery, whether it was the patient’s first surgery, whether the surgery was conducted in a hospital or a clinic, and whether the patient was sent home or to a long-term care facility after surgery.
A total of 60,031 adults received lung cancer surgery throughout the study period; of these, 54,509 were included in the final analysis after eliminating those who passed away in the hospital or within the first six months of release.
3325 patients (just over 6%) who had just been prescribed opioids were still using them six months after surgery. Of these, 859 (1.6%) were taking powerful medications, while 2466 (4.5%) were receiving less potent ones.
The probability of dying from any cause within the following two years increased with new long-term opioid usage; 17.5% (574/3325) of long-term opioid users passed away against 9.5% (4738/51,184) of non-users.
Compared to people who didn’t take opioids, new long-term opioid users were 40% more likely to die from any cause in the next two years.
Those who took less powerful opioids were still 22% more likely to die, while those who took more powerful opioids were 92% more likely to die.
Age, male sex, surgical procedures—particularly thoracotomies, which involve making a cut between the ribs—longer hospital stays, higher levels of disability, chemotherapy, and preoperative anxiety and insomnia were all linked to an increased risk of developing a new, long-term addiction.
As this is an observational study, the cause cannot be determined. The researchers also point out that they were unable to determine the tumor stage, smoking and drinking habits, or lung health prior to surgery, all of which may have influenced the results.
However, they point out that prior studies suggest that opioids may assist promote tumor growth, limit cancer cell death, and impair the immune system.
“This is the first study to identify the association of new long-term opioid use with poorer long-term survival outcomes after lung cancer surgery using real-world data based on a national registration database,” the authors write.
Image Credit: Getty
You were reading: New Long-term Opioid Users After Lung Cancer Surgery 40% More Likely To Die Within 2 Years