Risk Score of Minkowitz et al for Opioid-Related Adverse Drug Events (ORADE) in a Surgical Patient: Model for a Male Patient

Description

Minkowitz et al reported models for opioid-related adverse drug events (ORADE) in surgical patients. These can help to identify a patient at high risk for adverse events who may benefit from alternative analgesia. The authors are from Memorial Herman City Medical Center (Houston), Pacira Pharmaceuticals, and Xcenda (Palm Harbor).

Patient selection: male surgical patient

Parameters:

(1) age in years (age constraints not mentioned)

(2) history of prior opioid use

(3) obesity (ICD-9 278)

(4) COPD

(5) CHF

(6) benign prostatic hypertrophy (BPH)

(7) cardiac dysrhythmia

(8) diverticulitis

(9) ulcerative colitis

(10) obstructive sleep apnea

Parameter	Finding	Points
age in years		0.0128 * (years)
history of prior opioid use	no	0
	yes	0.3176
obesity	no	0
	yes	-0.8129
COPD	no	0
	yes	0.2925
CHF	no	0
	yes	0.4806
BPH	no	0
	yes	1.9851
cardiac dysrhythmia	no	0
	yes	1.4024
diverticulitis	no	0
	yes	0.6633
ulcerative colitis	no	0
	yes	2.0049
obstructive sleep apnea	no	0
	yes	0.6139

total score =

= SUM(points for all of the parameters) + 1.2528 (for male gender)

Interpretation:

• minimum score: 0.4399

• maximum score: determined by age, potentially > 10

• A score >= 1.7204 indicates a high risk for an opioid-related adverse drug event.

Performance:

• The area under the ROC curve is 0.734.

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Risk Score of Minkowitz et al for Opioid-Related Adverse Drug Events (ORADE) in a Surgical Patient: Model for a Male Patient

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