Preoperative Chronic Opioid Users in Total Knee Arthroplasty-Which Patients Persistently Abuse Opiates Following Surgery?
J Arthroplasty
; 33(1): 107-112, 2018 01.
Article
en En
| MEDLINE
| ID: mdl-28844770
ABSTRACT
BACKGROUND:
Chronic opioid users pose a unique challenge for orthopedic surgeons, as they often report suboptimal outcomes following total knee arthroplasty (TKA). We aim at identifying risk factors associated with patients who were preoperative chronic opioid users and continued to use 6 months following TKA.METHODS:
All preoperative chronic opioid users among 338 consecutive TKA cases performed at our institution between February and June 2016 were identified and divided into 2 cohorts patients who (1) persistently used opioids and (2) discontinued use by the 6-month time point following surgery. Baseline characteristics were compared between cohorts in order to determine risk factors for persistent opioid use following TKA.RESULTS:
Of the 338 patients, 53 (15.7%) were identified as preoperative chronic opioid users. Of these, 23 (43.4%) continued chronic opioid use 6 months following surgery, whereas 14 (4.9%) previously nonchronic users were identified as new chronic users at 6 months. Characteristics that were predictive of persistent opioid use included male gender, prior injury or surgery to the ipsilateral knee, current tobacco smoking status, and a history of psychiatric disorder. Opioid dose consumption of ≥12 mg/d morphine-equivalents over the 3 months leading up to surgery had an increased risk of persistent chronic opioid use by a factor of 6.CONCLUSION:
TKA candidates who have complicated medical, social, and surgical histories are at an increased risk of chronic opioid abuse postoperatively. By better understanding the risk factors associated with persistent chronic opioid use, targeted opioid reduction programs may be appropriately implemented to manage this high-risk population.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
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Artroplastia de Reemplazo de Rodilla
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Periodo Preoperatorio
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Analgésicos Opioides
/
Trastornos Relacionados con Opioides
Tipo de estudio:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Aged80
/
Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Arthroplasty
Asunto de la revista:
ORTOPEDIA
Año:
2018
Tipo del documento:
Article