Association between sex and perioperative opioid prescribing for total joint arthroplasty: a retrospective population-based study.
Br J Anaesth
; 126(6): 1217-1225, 2021 Jun.
Article
en En
| MEDLINE
| ID: mdl-33674073
ABSTRACT
BACKGROUND:
Scarce data exist on differential opioid prescribing between men and women in the pre-, peri-, and postoperative phases of care among patients undergoing total hip/knee arthroplasty (THA/TKA).METHODS:
In this retrospective population-based study, Truven Health MarketScan claims data were used to establish differences between men and women in (1) opioid prescribing in the year before THA/TKA surgery, (2) the amount of opioids prescribed at discharge, and (3) chronic opioid prescribing (3-12 months after surgery). Multivariable regression models measured odds ratios (OR) with 95% confidence intervals (95% CI).RESULTS:
Among 29 038 THAs (42% men) and 48 523 TKAs (52% men) men (compared with women) were less likely to receive an opioid prescription in the year before surgery (54% vs 60%, and 54% vs 60% for THA and TKA, respectively); P<0.001. However, in multivariable analyses male sex was associated with higher total opioid dosages prescribed at discharge after THA (OR=1.04; 95% CI 1.03, 1.06) and TKA (OR=1.05; 95% CI 1.04, 1.06); both P<0.001. Chronic opioid prescribing was found in 10% of the cohort (THA n=2333; TKA n=5365). Here, men demonstrated lower odds of persistent opioid prescribing specifically after THA (OR=0.90; 95% CI 0.82, 0.99) but not TKA (OR=0.96; 95% CI 0.90, 1.02); P=0.026 and P=0.207, respectively.CONCLUSIONS:
We found sex-based differences in opioid prescribing across all phases of care for THA/TKA. The results highlight temporal opportunities for targeted interventions to improve outcomes after total joint arthroplasty, particularly for women, and to decrease chronic opioid prescribing.Palabras clave
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
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Pautas de la Práctica en Medicina
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Artroplastia de Reemplazo de Cadera
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Artroplastia de Reemplazo de Rodilla
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Disparidades en Atención de Salud
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Manejo del Dolor
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Analgésicos Opioides
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Female
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Humans
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Male
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Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Br J Anaesth
Año:
2021
Tipo del documento:
Article