increases

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Opioid use increases risk of death in older adults after outpatient surgery, study says

Oct. 21 (UPI) — Older adults who used opioid pain medications before minor surgery were up to 68% more likely to die within 90 days of the procedure compared with those who never used the drugs, an analysis published Wednesday by JAMA Surgery found.

Even among people older than 65 who had low levels of opioid use as long as eight months before surgery, about 55 people per 10,000 in the general population died within 90 days of having a procedure, the data showed.

Older adults who had not used opioid pain drugs prior to surgery died at a rate of just over 40 per 10,000 in the general population within 90 days of having a minor procedure, the researchers said.

“People who have preoperative exposure to opioids have a higher risk of mortality after outpatient surgery,” study co-author Dr. Katherine Santosa told UPI.

“Although our analysis cannot discern the underlying causes for this, our findings highlight the need to screen for opioid-related risk prior to surgery,” said Santosa, a surgeon at Michigan Medicine.

Opioids were the leading cause of drug overdose deaths in the United States in the first half of 2019, according to data released recently by the U.S. Centers for Disease Control and Prevention.

Much of the country has been in the grips of an “epidemic” of illegal opioid use and overdose deaths over the past 40 years, causing more than 1 million deaths, based on agency estimates.

At least some of this increase in use has been attributed to over-prescription for pain treatment, the CDC has said.

For this study, Santosa and her colleagues reviewed data on more than 99,000 Medicare beneficiaries — age 65 and older — who had outpatient surgical procedures between 2009 and 2015.

Outpatient procedures do not entail an overnight hospital stay, and patients are admitted, have surgery and are discharged the same day.

Patients included in the analysis had procedures ranging from varicose vein removal and hemorrhoid removal to trans-urethral prostate surgery, thyroid removal, carpal tunnel release, umbilical hernia repair and inguinal hernia repair, the researchers said.

Among outpatient surgery patients included in the study, 0.48% died within 90 days of having their procedure, the data showed.

However, those with “high” levels of opioid use — for 10 months or more and within one month — before surgery were 68% more likely to die within 90 days of their procedure, the researchers said.

In addition, those with low or medium use before surgery were 30% more likely to die, the data showed.
“Many Americans currently use opioids prior to surgery for a variety of conditions,” Santosa said.

“In this context, it is important to understand the potential impact of opioids on recovery, and create care pathways to decrease the risk of adverse effects [while undergoing surgery],” she said.

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health

Coronavirus case increases hit record highs in at least 7 states

At least seven states have set new records for single-day increases in coronavirus cases, prompting some to set new restrictions as concerns mount over possible “superspreader events” during the upcoming holiday season.

Colorado, Idaho, Indiana, Minnesota, New Mexico, North Dakota and West Virginia all set records Friday in the number of new cases of the virus, NBC News’ tally shows.

Colorado recorded 1,312 cases Friday, the same day Denver’s mayor announced both a tougher mask mandate that requires residents to wear face coverings outdoors and a limit on gatherings in “unregulated settings” to no more than five people.

“Over the past several weeks, we have worked hard to reduce our caseloads and keep hospitalizations from increasing,” Mayor Michael Hancock said in a press release. “But we need to do more. With the holidays on the horizon, we must take these additional steps over the next 30 days and knuckle down together to do the hard work that needs to be done so we can all enjoy this upcoming holiday season.”

Full coverage of the coronavirus outbreak

The mask mandate remains in effect until further notice, while the limit on gatherings is through Nov. 16.

Idaho recorded 1,094 new cases Friday, while Indiana and Minnesota each reported more than 2,200 cases, according to NBC’s data.

The governor of Idaho, Brad Little, said Thursday that the state was going to stay in stage 4 of his reopening plan after having failed to meet the criteria for a full reopening for the ninth time in a row, the Idaho Statesman reported.

Little urged residents to continue wearing masks and practicing social distancing.

“Our personal actions work better to slow the spread of coronavirus than anything else,” the governor said, according to the outlet. “This is about personal responsibility, something Idaho is all about.”

Minnesota Health Commissioner Jan Malcolm said she was “very saddened” about the rise in cases, although she said some of it can be attributed to more testing.

“Some of the things that we maybe thought was O.K. to do a month or so ago is much, much riskier today just given this level of viral spread around our state,” she told MinnPost.

North Dakota and New Mexico also broke daily records Friday with 859 cases and 812, respectively. West Virginia and Wyoming each reported just under 500 new cases that day.

A spokeswoman for the New Mexico governor’s office called the increase in that state a “Covid-19 wildfire,” the Santa Fe New Mexican reported.

“The virus spreads when people give it the opportunity to spread, and New Mexicans are doing just that,” spokeswoman Nora Meyers Sackett said.

In Wisconsin, health officials urged residents not to gather with anyone outside of their immediate families.

“I think people should think about all of the things that they’re doing outside of the confines of their immediate families as a potential place that they could be coming into contact with Covid-19,” said Andrea Palm, with the state’s Department of Health Services. “Now

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