The relationship between preoperative opioid use and adverse events following total shoulder arthroplasty.

Autor: Kingston KA; Department of Orthopaedic Surgery and Rehabilitation Medicine, UChicago Medicine, Chicago, IL, USA., Qin C; Department of Orthopaedic Surgery and Rehabilitation Medicine, UChicago Medicine, Chicago, IL, USA., Qin M; Department of Orthopaedic Surgery, Northwestern Medicine, Chicago, IL, USA., Strelzow J; Department of Orthopaedic Surgery and Rehabilitation Medicine, UChicago Medicine, Chicago, IL, USA., Shi L; Department of Orthopaedic Surgery and Rehabilitation Medicine, UChicago Medicine, Chicago, IL, USA.
Jazyk: angličtina
Zdroj: Shoulder & elbow [Shoulder Elbow] 2023 Dec; Vol. 15 (6), pp. 653-657. Date of Electronic Publication: 2023 Mar 08.
DOI: 10.1177/17585732231161570
Abstrakt: Introduction: Few studies have analyzed the effect of preoperative opioid use on postoperative outcomes after total shoulder arthroplasty (TSA).
Methods: Patients undergoing TSA were identified in the Pearldiver Humana Claims Dataset and stratified by level of preoperative opioid use. Primary outcomes were 90-day complications, readmissions, and revision surgery. Chi-square test and ANOVA were used to evaluate categorical and continuous variables respectively. A multivariable logistic regression analysis and a sub analysis excluding fracture as a primary diagnosis were completed.
Results: 18,791 patients underwent aTSA and rTSA including 9933 opioid naïve patients, 3016 sporadic opioid users and 5842 persistent opioid users. Significant differences were found in complications (6.0% vs 6.1% vs 9.1%, p  < .001), readmission (7.6% vs 8.2% vs 12.6%, p  < .001), and revision procedures (1.1% vs 1.1% vs 2.3%, p  < .001) which remained significant after excluding fractures. After adjusting for comorbidity burden, persistent opioid use was associated with increased likelihood of complications (OR 1.4, 1.2-1.6), readmission (OR 1.6, 1.5-1.8) and revision procedures (OR 1.9, 1.5-2.4). This association remained after excluding fractures.
Conclusion: Persistent preoperative opioid use is associated with increased risk of early postoperative complications, readmission, and revision surgery for patients undergoing shoulder arthroplasty.
(© The Author(s) 2023.)
Databáze: MEDLINE
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