ACUTE PAIN RELATED LENGTH-OF-STAY AND MEDICATION USAGE FOLLOWING CARDIAC SURGERY

OBJECTIVES: Studies report a high prevalence of moderate to severe pain following surgery and data indicates that acute postsurgical pain is inadequately relieved in these patients. The objective of this retrospective study was to examine acute pain outcomes, particularly hospital length-of-stay (LOS) and medications administered following cardiac surgery using data from an electronic health record database. METHODS: Using a US electronic health record database (Cemer Health Facts®), we evaluated overall trends in pain measurement, treatment, and outcomes associated with acute postsurgical pain management of cardiac patients. Cardiac surgery (based on ICD9 code, 35.X-39.X) patients with at least one recorded pain score before and after surgery were included in the analysis. Hospital LOS and type of medications received were examined. RESULTS: Pre and post-operative pain was examined in cardiac surgery patients following surgery (n=367,836 from 2009-2015 for all cardiac surgery; mean age 62.8 yrs). Mean hospital postsurgical length-of-stay was 7.6 days. Following surgery, 74% of patients undergoing cardiac surgery were treated with polytherapy for pain (more than one type of pain medication administered). 71% of cardiac surgery patients received multimodal therapy (combination of opioid and non-opioid medications), 15% of patients received opioids only, and 14% received non-opioid only therapy. In the later stages of postoperative pain treatment (later stage refers to the use of treatment methods at the last time point where pain severity was assessed in the period of 14 days following surgery for each patient), 42% of patients received multimodal therapy, 25% received opioid only, and 34% received non-opioid only. CONCLUSIONS: Cardiac patients experience long hospital length-of-stays characterized by post-surgical pain treatment with mostly opioid-based methods. Later in the treatment period, there is a shift towards a less opioid-based pain treatment