S0019 Opioid Dependence and Outcomes in Total Pancreatectomy With Islet Autotransplantation in Patients With Chronic Pancreatitis

Abstract

INTRODUCTION: Total pancreatectomy with islet autotransplantation (TPIAT) is a surgical option for patients living with chronic pancreatitis. Many of these patients are dependent on chronic opioid therapy prior to surgery and we therefore studied the outcomes of these patients in comparison to non-opioid users using a national inpatient database. METHODS: The National Inpatient Sample (NIS) is the largest all-payer inpatient database in the United States. Data from the years 2008 to 2014 were collected. Patients older than 18 years with an admission diagnosis of chronic pancreatitis and who underwent total pancreatectomy with islet autotransplantation were included. Mortality, length of stay, and cost of hospitalization were measured amongst patients that were opioid dependent and those who were not. RESULTS: Between 2008 and 2014, there were 990 patients older than 18 years with chronic pancreatitis that underwent TPIAT. A total of 67 patients had a diagnosis of opioid abuse or dependence. Baseline patient demographics and hospital characteristics is available in Table 1. The majority of patients that underwent TPIAT were women in both groups. Surprisingly the majority of opioid dependence patients that underwent TPIAT were on the western part of the US and none were in the Midwest or Northeast. There was a total of two deaths in the non-opioid abuse group and none in the opioid group though this was not statistically significant. Length of stay (median 12 days vs. 11 days, P = 0.62) and cost of hospitalization ($68,938 vs. $60,412, P = 0.25) was higher in patients without opioid abuse but these outcomes were not statistically significant.Figure 1CONCLUSION: Opioid dependence does not seem to play a major role in some outcomes of TPIAT patients during their incident admission for surgery based on our data. However, this retrospective study does not give us long term outcomes of these patients and therefore prospective studies will need to be investigated to make the appropriate choices.