Predonation Prescription Opioid Use: A Novel Risk Factor for Readmission After Living Kidney Donation

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 hospit...

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Bibliographic Details
Published in:American journal of transplantation 2017-03, Vol.17 (3), p.744-753
Main Authors: Lentine, K. L., Lam, N. N., Schnitzler, M. A., Hess, G. P., Kasiske, B. L., Xiao, H., Axelrod, D., Garg, A. X., Schold, J. D., Randall, H., Dzebisashvili, N., Brennan, D. C., Segev, D. L.
Format: Article
Language:English
Subjects:
Adult
Analgesics, Opioid - therapeutic use
Consortia
donors and donation: living
Drug Prescriptions - statistics & numerical data
epidemiology
Female
Follow-Up Studies
Glomerular Filtration Rate
Graft Survival
Health risk assessment
health services and outcomes research
Humans
Kidney Failure, Chronic - surgery
Kidney Function Tests
Kidney Transplantation - methods
kidney transplantation/nephrology
Living Donors
Male
Narcotics
Nephrectomy
Patient Readmission - statistics & numerical data
Pharmacy
Prognosis
Registries
registry/registry analysis
risk assessment/risk stratification
Risk Factors
Tissue and Organ Harvesting - methods
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Summary: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
ISSN:1600-6135
1600-6143
DOI:10.1111/ajt.14033