Opioid Consumption After Rotator Cuff Repair

Robert W Westermann; Chris A Anthony; Nic Bedard; Natalie Glass; Matt Bollier; Carolyn M Hettrich; Brian R Wolf

doi:10.1016/j.arthro.2017.03.016

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Opioid Consumption After Rotator Cuff Repair

Journal article

Open access

Peer reviewed

Opioid Consumption After Rotator Cuff Repair

Robert W Westermann, Chris A Anthony, Nic Bedard, Natalie Glass, Matt Bollier, Carolyn M Hettrich and Brian R Wolf

Arthroscopy, Vol.33(8), pp.1467-1472

08/2017

DOI: 10.1016/j.arthro.2017.03.016

PMID: 28571723

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Abstract

Rising perioperative opioid use in the United States is of increasing concern. The purposes of this study were (1) to define opioid consumption after rotator cuff repair (RCR) in the United States and (2) to evaluate patient factors that may be associated with prolonged opioid use after arthroscopic RCR. All arthroscopic RCRs performed between 2007 and 2014 were identified by use of Current Procedural Terminology code (29,827). Patients who filled opioid prescriptions preoperatively were divided into those who filled prescriptions at 1 to 3 months preceding RCR and those who filled opioid prescriptions only in the 1 month preceding RCR. Risk ratios (RRs) were calculated by dividing the cumulative incidence of opioid prescriptions in patients with each patient factor by the cumulative incidence in those without each patient factor. During the study period, 35,155 arthroscopic RCRs were performed. Of the patients, approximately 43% had filled an opioid prescription in the 3 months before RCR. At 3 months after RCR, patients who filled opioid prescriptions at 1 to 3 months before RCR were 7.45 (95% confidence interval [CI], 6.95-7.98) times more likely to be filling opioid medication prescriptions than those who had not been prescribed opioid medications before surgery; patients who filled opioid prescriptions in the month before RCR were 3.04 (95% CI, 2.8-3.29) times more likely to be filling opioid prescriptions at 3 months after RCR. Patients with psychiatric diagnoses (RR, 1.94; 95% CI, 1.85-2.04), myalgia (RR, 1.67; 95% CI, 1.6-1.75), and low-back pain (RR, 2.09; 95% CI, 2-2.2) were also found to be at risk of filling opioid prescriptions at 3 months postoperatively. We found approximately 43% of patients undergoing RCR received opioid medications before RCR. Patients who are prescribed narcotics before RCR are at increased risk of postoperative opioid demand. Patients with psychiatric diagnoses, myalgia, and low-back pain may be at increased risk of prolonged opioid use after surgery. Level III, retrospective case-control study.

Rotator Cuff Injuries - surgery

United States

Humans

Middle Aged

Analgesics, Opioid - therapeutic use

Male

Case-Control Studies

Pain, Postoperative - prevention & control

Practice Patterns, Physicians' - statistics & numerical data

Analgesics, Opioid - adverse effects

Arthroscopy

Analgesics, Opioid - administration & dosage

Adult

Female

Aged

Retrospective Studies

Details

Title: Subtitle: Opioid Consumption After Rotator Cuff Repair
Creators: Robert W Westermann - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, U.S.A
Chris A Anthony - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, U.S.A.. Electronic address: chris-anthony@uiowa.edu
Nic Bedard - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, U.S.A
Natalie Glass - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, U.S.A
Matt Bollier - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, U.S.A
Carolyn M Hettrich - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, U.S.A
Brian R Wolf - Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, U.S.A
Resource Type: Journal article
Publication Details: Arthroscopy, Vol.33(8), pp.1467-1472
DOI: 10.1016/j.arthro.2017.03.016
PMID: 28571723
NLM abbreviation: Arthroscopy
ISSN: 0749-8063
eISSN: 1526-3231
Publisher: Elsevier; United States
Language: English
Date published: 08/2017
Academic Unit: Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science; Athletic Training Program
Record Identifier: 9984040274602771

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