Risk factors for persistent opioid use include prior substance abuse, smoking, increased body mass index, fracture fixation surgery.
One out of every six older hip fracture patients remains to be taking opioid pain medications three to 6 months after surgery, according to a study introduced on the annual assembly of the American Academy of Orthopaedic Surgeons, held from Aug. 31 to Sept. 3 in San Diego.
Kanu M. Okike, M.D., from the Kaiser Permanente Moanalua Medical Center in Honolulu, and colleagues assessed the prevalence of and risk elements for extended opioid utilization following hip fracture in opioid-naive older individuals. The analysis included 29,618 opioid-naive patients (aged ≥60 years) who underwent surgical treatment of a hip fracture at one of 35 hospitals owned by a big U.S. health maintenance organization between 2009 and 2018.
The researchers found that the proportion of outpatient opioid utilization was 83.7% from day 0 to day 30 after surgery, 69.0% from day 31 to day 90, and 16.7% from day 91 to day 180. Risk factors for persistent opioid utilization in an adjusted evaluation included youthful age (60 to 69 years), female sex, body mass index ≥30 kg/m², present/former smoking, American Society of Anesthesiologists classification ≥3, and a history of substance abuse. In distinction, persistent opioid utilization was much less commonly observed among patients who were Asian, had an annual income of ≥$150,000, or had undergone regional anesthesia. Persistent opioid usage was extra doubtless following fracture fixation surgery and less likely following whole hip arthroplasty (utilizing hemiarthroplasty because of the reference group).
“Whereas prior research on the hazards of opioids within the aged has primarily targeted on short-term risks such as oversedation and delirium, these outcomes recommend that dependency and chronic opioid use might characterize risks for this older population as properly,” the authors write.