Introduction Opioid derivates are an essential part of everyday clinical pain management
practice. They have excellent analgesic, sedative, and sympatholytic effects and are
widely used in various conditions. Beyond advantageous aspects, there are numerous
problems with the chronic use of these agents. Dependency and life-threatening complications
are the biggest problems with both illegal and prescribed opioid derivates. In our
current study, effects of chronic opioid use were observed on mortality and life quality
in the case of vascular surgery. Methods This prospective, observational study was
conducted between 2014 and 2017. After obtaining informed consent, all participants
were asked to fill a questionnaire containing different psychological tests. Perioperative
data, chronic medical therapy, and anthropometric data were also collected. Opioid
user and non-user patients' psychological results were compared with non-parametrical
tests. The effect of chronic opioid administration was investigated with logistic
regression method with bootstrapping. Results Finally, the data of 164 patients were
analyzed. 64.0% of participants were male, the mean age was 67.05 years, and the standard
deviation was 9.48 years. The median follow-up time was 1312 days [interquartile range
(IQR): 930-1582 days]. During the follow-up time, 42 patients died (25.6%). In the
examined patient cohort, the frequency of opioid derivate use was 3.7% (only six patients).
In the non-survived group, opioid use was significantly higher (1.6% vs. 9.5%, p=0.019).
Significant differences were found in the aspect of cognitive performance measured
by Mini-Mental State Examination (MMSE), opioid users have had lower points [25.5
(IQR: 24.5-26.0) vs. 28.0 (IQR: 27.0-29.0) p=0.008]. Opioid users have showed higher
score on Beck Depression Inventory (BDI) [15.5 (IQR: 10.0-18.0) vs. 6.0 (IQR: 3.0-11.0),
p=0.030). In a multivariate Cox regression model built up from registered preoperative
medical treatment, opioids were found as a risk factor for all-cause mortality [adjusted
hazard ratio (AHR): 4.31, 95% CI: 1.77-10.55, p=0.001]. Conclusion Our current findings
suggest that chronic, preoperative use of opioids could associate with increased mortality.
Furthermore, both decrease in cognitive performance and increased depression symptoms
were found in the opioid user cohorts which emphasize the importance of further risk
stratification of these patients.
