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Inpatient pain alleviation after orthopaedic trauma surgery-are we doing a good job?
Marmor, Meir T; Mahadevan, Varun; Solans, Belén P; Floren, Alexander; Jarlsberg, Leah; Cohen, Isaac; Savic, Rada.
Afiliação
  • Marmor MT; Department of Orthopedic Surgery, University of California, 2550 23rd Street, San Francisco, CA, 94110, USA. meir.marmor@ucsf.edu.
  • Mahadevan V; Department of Orthopedic Surgery, University of California, 2550 23rd Street, San Francisco, CA, 94110, USA.
  • Solans BP; Department of Bioengineering and Therapeutic Sciences, School of Pharmacy, University of California, San Francisco, CA, USA.
  • Floren A; Department of Bioengineering and Therapeutic Sciences, School of Pharmacy, University of California, San Francisco, CA, USA.
  • Jarlsberg L; Department of Bioengineering and Therapeutic Sciences, School of Pharmacy, University of California, San Francisco, CA, USA.
  • Cohen I; Department of Bioengineering and Therapeutic Sciences, School of Pharmacy, University of California, San Francisco, CA, USA.
  • Savic R; Department of Bioengineering and Therapeutic Sciences, School of Pharmacy, University of California, San Francisco, CA, USA.
Eur J Orthop Surg Traumatol ; 34(1): 569-576, 2024 Jan.
Article em En | MEDLINE | ID: mdl-37650973
PURPOSE: Poor pain alleviation (PPA) after orthopaedic surgery is known to increase recovery time, readmissions, patient dissatisfaction, and lead to chronic postsurgical pain. This study's goal was to identify the magnitude of PPA and its risk factors in the orthopaedic trauma patient population. METHODS: A single-institution's electronic medical records from 2015 to 2018 were available for retrospective analysis. Inclusion criteria included orthopaedic fracture surgery patients admitted to the hospital for 24 h or more. Collected variables included surgery type, basic demographics, comorbidities, inpatient medications, pain scores, and length of stay. PPA was defined as a pain score of ≥ 8 on at least three occasions 4-12 h apart. Associations between collected variables and PPA were derived using a multivariable logistic regression model and expressed in adjusted odds ratios. RESULTS: A total of 1663 patients underwent fracture surgeries from 2015 to 2018, and 25% of them reported PPA. Female sex, previous use of narcotics, increased ASA, increased baseline pain score, and younger age without comorbidities were identified as significant risk factors for PPA. Spine procedures were associated with increased risk of PPA, while procedures in the hip, shoulder, and knee had reduced risk. Patients experiencing PPA were less likely to receive NSAIDs compared to other pain medications. CONCLUSIONS: This study found an unacceptably high rate of PPA after fracture surgery. While the identified risk factors for PPA were all non-modifiable, our results highlight the necessity to improve application of current multimodal approaches to pain alleviation including a more personalized approach to pain alleviation.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Ortopedia / Fraturas Ósseas Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Female / Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Ortopedia / Fraturas Ósseas Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Female / Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article