title: In-hospital use of opioids increases rate of coded postoperative paralytic ileus.
abstract: OBJECTIVE
  To determine the association between opioid use and the occurrence of postoperative paralytic ileus (POI) after different types of surgery.
  
  
  METHODS
  The PHARMO database was used to perform a case control study in which intramural drug utilisation data were linked to hospital discharge diagnoses. All patients admitted for digestive, abdominal or genito-urinary surgeries were selected in 1998-2003. Cases with coded POI (ICD-9-CM 560.1 and 564.4) and controls with no POI were matched 1:10. The association between coded POI and opioid use was assessed using conditional logistic regression.
  
  
  RESULTS
  In 0.2% of all admissions (total of 180,279), patients developed POI and in 18% of all admissions, patients received opioids. Three hundred and sixty-six cases with POI were selected with their matching controls. The use of (nico)morphine was associated with the risk for developing POI (odds ratio (OR) 12.1, 95% confidence interval (CI) 5.4-27.1). The association between opioids and POI was most obvious in patients with abdominal surgery (OR 33.8, 95% CI 6.2-184.6) and patients without colon/colorectal/rectal tumours (OR 13.2, 95%CI 5.7-30.3).
  
  
  CONCLUSIONS
  This study demonstrated a distinct association between the use of opioids, in particular natural opium alkaloids, and the risk for coded POI.
authors.affiliation: PHARMO Institute, Utrecht, The Netherlands.
authors.forename: Wim G
authors.initials: WG
authors.lastname: Goettsch
authors.forename: Myrthe P P
authors.initials: MP
authors.lastname: Sukel
authors.forename: Donald L
authors.initials: DL
authors.lastname: van der Peet
authors.forename: Melanie M
authors.initials: MM
authors.lastname: van Riemsdijk
authors.forename: Ron M C
authors.initials: RM
authors.lastname: Herings
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D045823:Ileus / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid