Health outcomes and resource utilization associated with postsurgical opioid use among cancer patients undergoing curative-intent surgery.
Bibliographic record
Abstract
6515 Background: To date, it remains unclear whether new persistent post-surgical opioid use is associated with subsequent opioid overdose, higher mortality and greater consumption of healthcare resources among cancer patients. To fill this gap, a population-based cohort study by applying real-world data has been performed to compare the long-term outcomes and healthcare resource use between new persistent and non-persistent opioid users among cancer patients after curative-intent surgery. Methods: This retrospective cohort study included all adult cancer patients with solid tumours who received curative-intent surgery in Alberta between 2011 and 2015, with a follow-up period until December 31, 2019. Patients who had multiple tumors, or had a follow-up < 6 months, or > 30 days of hospitalization were excluded. A new persistent post-surgical opioid user was defined as a patient who was opioid-naïve before surgery (no opioid prescription filled prior to the surgery) and subsequently filled at least one opioid prescription between 60 and 180 days after surgery. The outcomes (opioid overdose and mortality within 3 years) and health resource use (emergency department visits and hospitalization within the first year) after surgery were evaluated by applying multivariable logistic and Cox regressions. Results: A total of 19,219 patients received curative-intent surgery with a median follow-up of 47 months, of which 1,530 (8.0%) were identified as postoperative new persistent opioid users. Compared with the non-persistent group, a higher rate of opioid overdose (OR = 1.81, 95% CI: 1.49-2.2) within 3 years of surgery has been observed for new persistent opioid users, who were also associated with a greater likelihood of being hospitalized (OR = 2.52, 95% CI: 2.21-2.87) and visiting an emergency room (OR = 2.0, 95% CI: 1.78-2.24) within the first year after surgery. A higher overall (HR = 1.37, 95% CI: 1.2-1.57) and non-cancer caused mortality (HR = 1.39, 95% CI: 1.18-1.65) has also been detected for new persistent opioid users during the study follow-up period. Conclusions: For cancer patients undergoing curative-intent surgery, reducing new persistent opioid use is imperative to improve subsequent outcomes and health resource utilization.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".