Journal article
Preoperative Opioid Prescription Filling Is a Risk Factor for Prolonged Opioid Use After Elbow Arthroscopy
Arthroscopy, Vol.36(8), pp.2106-2113
08/2020
DOI: 10.1016/j.arthro.2020.04.053
PMID: 32442710
Abstract
To (1) report the frequency of postoperative opioid prescriptions after elbow arthroscopy, (2) evaluate whether filling opioid prescriptions preoperatively placed patients at increased risk of requiring more opioid prescriptions after surgery, and (3) determine patient factors associated with postoperative opioid prescription needs.
A national claims-based database was queried for patients undergoing primary elbow arthroscopy. Patients with prior total elbow arthroplasty or septic arthritis of the elbow were excluded. Patients who filled at least 1 opioid prescription between 1 and 4 months prior to surgery were defined as the preoperative opioid-use group. Monthly relative risk ratios for filling an opioid prescription were calculated for the first year after surgery. Multiple logistic regression analysis was performed to identify factors associated with opioid use at 3, 6, 9, and 12 months after elbow arthroscopy, with P < .05 defined as significant.
We identified 1,138 patients who underwent primary elbow arthroscopy. The preoperative opioid-use group consisted of 245 patients (21.5%), 61 of whom (24.9%) were still filling opioid prescriptions 12 months after surgery. The multivariate analysis determined that the preoperative opioid-use group was at increased risk of postoperative opioid prescription filling at 3 months (odds ratio [OR], 9.02; 95% confidence interval [CI], 5.98-13.76), 6 months (OR, 8.74; 95% CI, 5.57-13.92), 9 months (OR, 7.17; 95% CI, 4.57-11.39), and 12 months (OR, 6.27; 95% CI, 3.94-10.07) after elbow arthroscopy. Patients younger than 40 years exhibited a decreased risk of postoperative opioid prescription filling at 3 months (OR, 0.49; 95% CI, 0.25-0.91), 6 months (OR, 0.19; 95% CI, 0.06-0.50), 9 months (OR, 0.48; 95% CI, 0.22-0.97), and 12 months (OR, 0.44; 95% CI, 0.19-0.94) after surgery.
Preoperative opioid filling, fibromyalgia, and psychiatric illness are associated with an increased risk of prolonged postoperative opioid after elbow arthroscopy. Patient age younger than 40 years and chronic obstructive pulmonary disease are associated with a decreased risk of postoperative opioid prescription filling within the first postoperative year.
Level III, retrospective cohort study.
Details
- Title: Subtitle
- Preoperative Opioid Prescription Filling Is a Risk Factor for Prolonged Opioid Use After Elbow Arthroscopy
- Creators
- Edward O Rojas - University of Iowa Hospitals and ClinicsZain M Khazi - University of Iowa Hospitals and ClinicsTrevor R Gulbrandsen - University of IowaAlan G Shamrock - University of IowaChristopher A Anthony - From the Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.AKyle Duchman - University of IowaRobert W Westermann - University of IowaBrian R Wolf - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Arthroscopy, Vol.36(8), pp.2106-2113
- DOI
- 10.1016/j.arthro.2020.04.053
- PMID
- 32442710
- NLM abbreviation
- Arthroscopy
- ISSN
- 0749-8063
- eISSN
- 1526-3231
- Publisher
- Elsevier
- Grant note
- DOI: 10.13039/100007307, name: Arthrex
- Language
- English
- Date published
- 08/2020
- Academic Unit
- Orthopedics and Rehabilitation; Physical Therapy and Rehabilitation Science; Athletic Training Program
- Record Identifier
- 9984295055702771
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