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European Journal of Orthopaedic Surgery & Traumatology

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01-05-2020 | Opioids | Original Article

Risk factors associated with persistent chronic opioid use following THA

Authors: Afshin A. Anoushiravani, Kelvin Y. Kim, Mackenzie Roof, Kevin Chen, Casey M. O’Connor, Jonathan Vigdorchik, Ran Schwarzkopf

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 4/2020

Abstract

Introduction

An understanding of patient characteristics associated with persistent chronic opioid use after total joint arthroplasty (TJA) will allow surgeons to better manage these patients. Our study aims to identify risk factors among preoperative chronic opioid users who continue to chronically use narcotics after total hip arthroplasty (THA).

Methods

A retrospective analysis was performed on 256 THA recipients using the state’s mandated opioid monitoring program to identify preoperative chronic opioid users. Chronic users were stratified into two cohorts based on their use 6 months after surgery: (1) persistent chronic and (2) previous chronic users. Patient demographics and relevant histories were abstracted and comparatively assessed between the cohorts. In addition, an analysis was performed to calculate which preoperative opioid dose was most predictive of chronic use.

Results

Within the study population, 54 patients were identified as preoperative chronic opioid users. Of them, 13 (24.1%) were identified as persistent chronic users 6 months following surgery. Specific characteristics associated with a higher likelihood of persistent chronic opioid use included: male gender, ASA score > 2, and Medicare as a payer type. A 33 mg/day morphine-equivalent dose consumption prior to surgery was most predictive for persistent chronic opioid use.

Conclusion

Our study demonstrates that patients who are male, have an ASA > 2, and use Medicare are at greater risk of persistent chronic opioid use. Thus, given the poor outcomes associated with chronic opioid use, these findings may help guide surgeons’ clinical decision-making process when encountering patients with a history of opioid use.

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Title: Risk factors associated with persistent chronic opioid use following THA
Authors: Afshin A. Anoushiravani
Kelvin Y. Kim
Mackenzie Roof
Kevin Chen
Casey M. O’Connor
Jonathan Vigdorchik
Ran Schwarzkopf
Publication date: 01-05-2020
Publisher: Springer Paris
Keywords: Opioids
Opioids
Hip-TEP
Hip-TEP
Anesthetics
Anesthetics
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 4/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02618-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Risk factors associated with persistent chronic opioid use following THA

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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