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Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study.

Publication ,  Journal Article
Kim, Y; Zhang, F; Su, K; LaRochelle, M; Callahan, M; Fisher, D; Wharam, JF; Asgari, MM
Published in: J Gen Intern Med
September 2020

IMPORTANCE: Vitamin D deficiency is associated with chronic pain syndromes and higher opioid use among cancer patients, but its association with opioid use among opioid-naïve subjects following a major surgical procedure with acute pain has not been explored. OBJECTIVE: To determine the association between serum 25-hydroxyvitamin D (25(OH)D) levels, opioid use, and opioid use disorder. METHODS: We identified commercially insured subjects aged 18-64 years with available perioperative serum 25-hydroxyvitamin D (25D) levels who underwent one of nine major surgical procedures in 2000-2014. Primary outcomes were dose and duration of opioid use measured using pharmacy claims. Secondary outcome was opioid use disorder captured using diagnosis codes. Multivariable negative binomial models with generalized estimating equations were performed examining the association between 25D levels and postoperative opioid use measures, adjusting for age, sex, race/ethnicity, Charlson score, education, income, latitude, and season of blood draw. Adjusted Cox regression was used to examine the association with opioid use disorder. RESULTS: Among 5446 subjects, serum 25(OH)D was sufficient (≥ 20 ng/mL) among 4349 (79.9%) subjects, whereas 837 (15.4%) had insufficient (12 to < 20 ng/mL) and 260 (4.8%) had deficient (< 12 ng/mL) levels. On multivariable analysis, as compared with subjects with sufficient 25(OH)D levels, subjects with deficient 25(OH)D levels had 1.7 more days (95% CI 0.76, 2.58) of opioid use per year and had 98.7 higher morphine milligram equivalent dose (95% CI 55.7, 141.8) per year. Among 11,713 study cohort, subjects with deficient 25(OH)D levels were more likely to be diagnosed with opioid use disorders (HR 2.41; 95% CI 1.05, 5.52). CONCLUSION: Patients undergoing common surgical procedures with deficient 25D levels are more likely to have higher opioid use and an increased risk of opioid use disorder compared to those with sufficient levels. Serum 25D levels may serve as a biomarker to identify subjects at increased risk of opioid misuse.

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Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

September 2020

Volume

35

Issue

9

Start / End Page

2545 / 2552

Location

United States

Related Subject Headings

  • Young Adult
  • Vitamin D
  • Risk Factors
  • Opioid-Related Disorders
  • Middle Aged
  • Humans
  • General & Internal Medicine
  • Cohort Studies
  • Analgesics, Opioid
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
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Kim, Y., Zhang, F., Su, K., LaRochelle, M., Callahan, M., Fisher, D., … Asgari, M. M. (2020). Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study. J Gen Intern Med, 35(9), 2545–2552. https://doi.org/10.1007/s11606-020-06001-y
Kim, Yuhree, Fang Zhang, Katherine Su, Marc LaRochelle, Matthew Callahan, David Fisher, J Frank Wharam, and Maryam M. Asgari. “Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study.J Gen Intern Med 35, no. 9 (September 2020): 2545–52. https://doi.org/10.1007/s11606-020-06001-y.
Kim Y, Zhang F, Su K, LaRochelle M, Callahan M, Fisher D, et al. Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study. J Gen Intern Med. 2020 Sep;35(9):2545–52.
Kim, Yuhree, et al. “Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study.J Gen Intern Med, vol. 35, no. 9, Sept. 2020, pp. 2545–52. Pubmed, doi:10.1007/s11606-020-06001-y.
Kim Y, Zhang F, Su K, LaRochelle M, Callahan M, Fisher D, Wharam JF, Asgari MM. Perioperative Serum 25-Hydroxyvitamin D Levels as a Predictor of Postoperative Opioid Use and Opioid Use Disorder: a Cohort Study. J Gen Intern Med. 2020 Sep;35(9):2545–2552.
Journal cover image

Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

September 2020

Volume

35

Issue

9

Start / End Page

2545 / 2552

Location

United States

Related Subject Headings

  • Young Adult
  • Vitamin D
  • Risk Factors
  • Opioid-Related Disorders
  • Middle Aged
  • Humans
  • General & Internal Medicine
  • Cohort Studies
  • Analgesics, Opioid
  • Adult