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Sarcopenia is associated with an increase in long-term use of analgesics after elective surgery under general anesthesia
  1. Mingyang Sun1,
  2. Wan-Ming Chen2,3,
  3. Szu-Yuan Wu2,3,4,5,6,7,8,9,10 and
  4. Jiaqiang Zhang1
  1. 1Department of Anesthesiology and Perioperative Medicine, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, Henan, China
  2. 2Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan
  3. 3Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei, Taiwan
  4. 4Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan
  5. 5Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
  6. 6Division of Radiation Oncology, Lo-Hsu Medical Foundation, LotungPoh-Ai Hospital, Yilan, Taiwan
  7. 7Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
  8. 8Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan
  9. 9Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
  10. 10Department of Management, College of Management, Fo Guang University, Yilan, Taiwan
  1. Correspondence to Professor Szu-Yuan Wu, Asia University, Taichung 41354, Taiwan; szuyuanwu5399{at}gmail.com; Professor Jiaqiang Zhang, Zhengzhou University, Zhengzhou 450052, People's Republic of China; zhangjiq{at}zzu.edu.cn

Abstract

Purpose To elucidate the association of presurgical sarcopenia and long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia.

Methods We conducted this population-based propensity score matched to investigate the effects of sarcopenia and long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia between 1 October 2016 and 31 December 2019 from Taiwan’s National Health Insurance Research Database. Sarcopenia is a disease and coded as M62.84 in the International Classification of Diseases, 10th Revision, Clinical Modification. The primary outcome was the combined rate of the long-term use of all non-opioid analgesics or opioids over 3 and 6 months after elective surgery. By performing a logistic regression analysis, we calculated the adjusted ORs (aORs) with 95% CIs to identify the independent predictors for long-term non-opioid analgesic and opioid use after surgery.

Results In total, 2860 patients underwent elective surgery. The 3-month non-opioid analgesic and opioid use rates were respectively 49.7% and 1.8% in the sarcopenia group and 37.9% and 0.9% in the non-sarcopenia group; by contrast, 6-month non-opioid analgesic and opioid use rates were respectively 31.6% and 1.2% in the sarcopenia group and 17.2% and 0.3% in the non-sarcopenia group. Moreover, presurgical sarcopenia increased the risk of long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia (aORs for non-opioid analgesic use over 3 and 6 months after surgery: 1.17 (95% CI 1.05 to 2.23) and 1.26 (95% CI 1.04 to 1.45), respectively; aORs for opioid use over 3 and 6 months after surgery: 1.17 (95% CI 1.07 to 2.21) and 1.23 (95% CI 1.10 to 3.64), respectively).

Conclusion Sarcopenia is associated with higher rates of long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia.

Summary The aim of this study was to compare the long-term use of non-opioid analgesics and opioids after elective surgery under general anesthesia between patients with and without sarcopenia. Results suggest that patients with sarcopenia are more likely to have increased use of non-opioid analgesics and opioids after surgery. Further research is needed to determine if sarcopenia can be modified prior to surgery and if this impacts the need for long-term pain management with these medications.

  • Analgesics, Opioid
  • Pain, Postoperative
  • Pain Management

Data availability statement

Data may be obtained from a third party and are not publicly available. The data sets supporting the study conclusions are included in the manuscript. We used data from the National Health Insurance Research Database and Taiwan Cancer Registry database. The authors confirm that, for approved reasons, some access restrictions apply to the data underlying the findings. The data used in this study cannot be made available in the manuscript, the supplemental files, or in a public repository due to the Personal Information Protection Act executed by Taiwan’s government, starting in 2012. Requests for data can be sent as a formal proposal to obtain approval from the ethics review committee of the appropriate governmental department in Taiwan. Specifically, links regarding contact info for which data requests may be sent to are as follows: http://nhird.nhri.org.tw/en/Data_Subsets.html%23S3 and http://nhis.nhri.org.tw/point.html. Informed consent was waived because the data sets are covered under the Personal Information Protection Act. S-YW had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Data availability statement

Data may be obtained from a third party and are not publicly available. The data sets supporting the study conclusions are included in the manuscript. We used data from the National Health Insurance Research Database and Taiwan Cancer Registry database. The authors confirm that, for approved reasons, some access restrictions apply to the data underlying the findings. The data used in this study cannot be made available in the manuscript, the supplemental files, or in a public repository due to the Personal Information Protection Act executed by Taiwan’s government, starting in 2012. Requests for data can be sent as a formal proposal to obtain approval from the ethics review committee of the appropriate governmental department in Taiwan. Specifically, links regarding contact info for which data requests may be sent to are as follows: http://nhird.nhri.org.tw/en/Data_Subsets.html%23S3 and http://nhis.nhri.org.tw/point.html. Informed consent was waived because the data sets are covered under the Personal Information Protection Act. S-YW had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Footnotes

  • MS and W-MC contributed equally.

  • S-YW and JZ contributed equally.

  • Contributors Conception and design: Mingyang Sun; Wan-Ming Chen; Szu-Yuan Wu; Jiaqiang Zhang. Collection and assembly of data: Mingyang Sun; Wan-Ming Chen. Data analysis and interpretation: S-YW. Administrative support: S-YW. Manuscript writing: Mingyang Sun; Wan-Ming Chen; Szu-Yuan Wu; Jiaqiang Zhang. Guarantor: Mingyang Sun. Final approval of manuscript: all authors.

  • Funding Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, supports the work of S-YW (funding numbers: 11001, 11010, 11013 and 11103).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.