Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers

Robert W Westermann; Richard C Mather III; Nicholas A Bedard; Christopher A Anthony; Natalie A Glass; T Sean Lynch; Kyle R Duchman

doi:10.1016/j.arthro.2018.08.056

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Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers

Journal article

Peer reviewed

Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers

Robert W Westermann, Richard C Mather III, Nicholas A Bedard, Christopher A Anthony, Natalie A Glass, T Sean Lynch and Kyle R Duchman

Arthroscopy, Vol.35(2), pp.453-460

02/2019

DOI: 10.1016/j.arthro.2018.08.056

PMID: 30612773

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Abstract

To determine pre- and postoperative opioid utilization while identifying risk factors for prolonged postoperative opioid use following hip arthroscopy. All patients undergoing hip arthroscopy between 2007 and the second quarter of 2016 were identified within the Humana Inc. administrative claims database. Chronic preoperative opioid utilization was defined as filling of any opioid prescription 1 to 3 months before surgery, whereas acute preoperative opioid utilization was defined as filling any opioid prescription within 1 month of surgery. Rates of pre- and postoperative opioid utilization were calculated, and patient demographic characteristics and medical conditions associated with pre- and postoperative opioid utilization were identified. Of the 1,208 patients undergoing hip arthroscopy, chronic and acute preoperative opioid utilization was observed in 24.9% and 17.3% of patients, respectively. Chronic preoperative opioid utilization was more frequently observed in obese (P < .001) patients, those ≥50 years of age (P = .002), and those with preexisting anxiety and/or depression (P < .001). In multivariate analysis, chronic preoperative opioid utilization was the strongest predictor of opioid prescription filling at 3, 6, 9, and 12 months postoperatively (odds ratio at 3 months, 18.60, 95% confidence interval, 12.41 to 28.55), whereas preexisting anxiety and/or depression and obesity were additionally identified as predictors of prolonged postoperative opioid utilization. Chronic preoperative opioid utilization before hip arthroscopy is common at 24.9%. The high rate of chronic preoperative opioid utilization is particularly important considering that chronic preoperative opioid utilization is the strongest predictor of continued postoperative opioid prescription filling out to 12 months postoperatively. Level IV, retrospective case series.

United States - epidemiology

Depression - epidemiology

Age Factors

Hip Joint - surgery

Humans

Middle Aged

Postoperative Period

Analgesics, Opioid - therapeutic use

Male

Drug Prescriptions - statistics & numerical data

Arthroscopy

Obesity - epidemiology

Anxiety - epidemiology

Female

Retrospective Studies

Databases, Factual

Preoperative Period

Details

Title: Subtitle: Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers
Creators: Robert W Westermann - Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
Richard C Mather III - Duke University Medical Center, Durham, North Carolina, U.S.A
Nicholas A Bedard - Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
Christopher A Anthony - Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
Natalie A Glass - Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
T Sean Lynch - Columbia University Medical Center, New York, New York, U.S.A
Kyle R Duchman - Department of Orthopedics & Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A.; Duke University Medical Center, Durham, North Carolina, U.S.A.. Electronic address: kyle-duchman@uiowa.edu
Resource Type: Journal article
Publication Details: Arthroscopy, Vol.35(2), pp.453-460
DOI: 10.1016/j.arthro.2018.08.056
PMID: 30612773
NLM abbreviation: Arthroscopy
ISSN: 0749-8063
eISSN: 1526-3231
Publisher: Elsevier; United States
Grant note: DOI: 10.13039/100009026, name: Smith & Nephew
Language: English
Date published: 02/2019
Academic Unit: Orthopedics and Rehabilitation; Athletic Training Program
Record Identifier: 9984040290202771

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