Preoperative Opioid Use Negatively Affects Patient-reported Outcomes After Primary Total Hip Arthroplasty
Autor: | John Z Zhao, Christian Klemt, Young-Min Kwon, David W. Fitz, Bryant Bonner, Tiffany N. Castillo |
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Rok vydání: | 2019 |
Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Arthroplasty Replacement Hip MEDLINE Osteoarthritis Preoperative care 03 medical and health sciences 0302 clinical medicine Preoperative Care Medicine Humans Orthopedics and Sports Medicine Patient Reported Outcome Measures Aged 030222 orthopedics Rehabilitation business.industry 030229 sport sciences Length of Stay Middle Aged medicine.disease Arthroplasty United States Analgesics Opioid Opioid Anesthesia Orthopedic surgery Surgery Female Implant business medicine.drug |
Zdroj: | The Journal of the American Academy of Orthopaedic Surgeons. 27(22) |
ISSN: | 1940-5480 |
Popis: | BACKGROUND Opioid use is a public health crisis in the United States and an area of increased focus in orthopaedic surgery. The aim of this study is to investigate whether preoperative opioid use had any effect on patient-reported outcome measures (PROMs) before and after total hip arthroplasty (THA). METHODS A total of 389 patients with THA with both preoperative and postoperative PROMs were reviewed: (1) 76 patients with preoperative opioid use (24%) and (2) 237 patients without preoperative opioid use (76%). Patient demographics and clinical information including opioid use, length of stay, and implant information. RESULTS Preoperative opioid users were more likely to stay in the hospital longer (P = 0.004) and be discharged to a rehabilitation facility (P = 0.038). Postoperatively, the Physical Function Short Form 10a (P = 0.021) and Patient-Reported Outcomes Measurement Information System Global-10 (P < 0.001 physical, P = 0.001, mental) were significantly lower in the preoperative opioid users. Within groups, both nonusers and preoperative opioid users saw improvements after THA in Hip Disability and Osteoarthritis Outcome Score-Physical Function Short Form (P < 0.001), Short Form 10a (P < 0.001), and Patient-Reported Outcomes Measurement Information System Global-10 (P < 0.001, physical and P = 0.008, mental). DISCUSSION Although all patients reported improvements after THA regardless of preoperative opioid use, preoperative opioid users undergoing THA had significantly lower patient-reported outcome scores, longer hospital stays, and a more likely discharge to rehabilitation. |
Databáze: | OpenAIRE |
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