Predictors of continued opioid use 6 months after total joint arthroplasty: a multi-site study.
Arch Orthop Trauma Surg
; 142(12): 4033-4039, 2022 Dec.
Article
em En
| MEDLINE
| ID: mdl-34846586
ABSTRACT
PURPOSE:
Continued opioid use after total knee and hip arthroplasty (TKA/THA) is well-documented and associated with both surgical and patient-reported factors. Research examining the combined effects of a multitude of factors on continued, and even chronic, opioid use in a systematic algorithmic manner is lacking. This study prospectively evaluated the combined effect of patient-related and surgical factors associated with continued opioid use after TKA/THA.METHODS:
From 2016 to 2018, 198 participants undergoing TKA or THA were recruited from two tertiary care facilities. Participants completed surveys before surgery and at 2 weeks, 1, 3, and 6 months following surgery. A LASSO approach, followed by an exhaustive covariate selection procedure, was used to build a multivariable mixed-effects logistic regression model estimating the odds ratio of continued postoperative opioid use based on surgical factors and patient-reported factors.RESULTS:
Approximately half of the participants underwent either TKA (49%) or THA (51%). Preoperatively, 15% of participants reported taking opioid medication. Opioid use decreased from 68% at 2-week follow-up to 7% by 6 months. In addition, preoperative opioid use (95% CI 1.07-4.37), increased pain (95% CI 1.21-1.62), elevated preoperative Pain Catastrophizing Scale scores (95% CI 1.01-1.04), lower Physical Function scores (95% CI 0.87-0.95), and participants undergoing TKA, compared to THA, (95% CI 0.25-0.67) were found to be significantly associated with continued postoperative opioid use up to 6 months.CONCLUSION:
Preoperative opioid use, average pain, reduced physical function, and TKA were significantly associated with continued postoperative opioid use. Findings illustrate the need for preoperative and longitudinal assessment of patient-reported outcomes to mitigate poor postoperative pain outcomes. LEVEL OF EVIDENCE II.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Artroplastia de Quadril
/
Artroplastia do Joelho
/
Transtornos Relacionados ao Uso de Opioides
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Arch Orthop Trauma Surg
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos