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Opioid use after total hip arthroplasty surgery is associated with revision surgery
BACKGROUND: Pain is an indication for total hip arthroplasty (THA) and it should be resolved post-surgery. Because patients’ pain is typically treated pharmacologically we tested whether opioid use can be used as a surrogate for patient-reported pain and as an indicator for early surgical failure. S...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785728/ https://www.ncbi.nlm.nih.gov/pubmed/26965992 http://dx.doi.org/10.1186/s12891-016-0970-6 |
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author | Inacio, Maria C. S. Pratt, Nicole L. Roughead, Elizabeth E. Paxton, Elizabeth W. Graves, Stephen E. |
author_facet | Inacio, Maria C. S. Pratt, Nicole L. Roughead, Elizabeth E. Paxton, Elizabeth W. Graves, Stephen E. |
author_sort | Inacio, Maria C. S. |
collection | PubMed |
description | BACKGROUND: Pain is an indication for total hip arthroplasty (THA) and it should be resolved post-surgery. Because patients’ pain is typically treated pharmacologically we tested whether opioid use can be used as a surrogate for patient-reported pain and as an indicator for early surgical failure. Specifically, we evaluated whether the amount of opioids taken within the year after THA was associated with one and five years risk of revision surgery. METHODS: A cohort of 9943 THAs (01/2001-12/2012) was evaluated. Post-operative opioid use was the exposure of interest and cumulative daily oral morphine equivalent (OME) amounts were calculated. Total OMEs/90-day periods were categorised into quartiles. Revisions within one and five years were the outcomes of interest. RESULTS: Of the THAs, 2.0 % (N = 200) were revised within one year and 4.2 % (N = 413) within five years. After adjustments for gender, age, surgical indication, co-morbidities, and other analgesics, revision was associated with amount of OMEs in the second quarter after THA (days 91–180 after discharge). Patients on medium-high amounts of OME (400-1119 mg) had higher risk of one (hazard ratio (HR) = 2.22, 95 % CI 1.08-4.56) and five year (HR = 1.66, 95 % CI 1.08-2.56) revision than a patient not taking opioids. During the same period, patients taking the highest amounts of OMEs (≥1120 mg) had a 2.64 (95 % CI 1.03-6.74) times higher risk of one year and a 2.11 (95 % CI 1.13-3.96) times higher risk of five year revision. CONCLUSIONS: Opioid use 91–180 days post-surgery is associated with higher risk of revision surgery and therefore is an early and useful indicator for surgical failure. |
format | Online Article Text |
id | pubmed-4785728 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47857282016-03-11 Opioid use after total hip arthroplasty surgery is associated with revision surgery Inacio, Maria C. S. Pratt, Nicole L. Roughead, Elizabeth E. Paxton, Elizabeth W. Graves, Stephen E. BMC Musculoskelet Disord Research Article BACKGROUND: Pain is an indication for total hip arthroplasty (THA) and it should be resolved post-surgery. Because patients’ pain is typically treated pharmacologically we tested whether opioid use can be used as a surrogate for patient-reported pain and as an indicator for early surgical failure. Specifically, we evaluated whether the amount of opioids taken within the year after THA was associated with one and five years risk of revision surgery. METHODS: A cohort of 9943 THAs (01/2001-12/2012) was evaluated. Post-operative opioid use was the exposure of interest and cumulative daily oral morphine equivalent (OME) amounts were calculated. Total OMEs/90-day periods were categorised into quartiles. Revisions within one and five years were the outcomes of interest. RESULTS: Of the THAs, 2.0 % (N = 200) were revised within one year and 4.2 % (N = 413) within five years. After adjustments for gender, age, surgical indication, co-morbidities, and other analgesics, revision was associated with amount of OMEs in the second quarter after THA (days 91–180 after discharge). Patients on medium-high amounts of OME (400-1119 mg) had higher risk of one (hazard ratio (HR) = 2.22, 95 % CI 1.08-4.56) and five year (HR = 1.66, 95 % CI 1.08-2.56) revision than a patient not taking opioids. During the same period, patients taking the highest amounts of OMEs (≥1120 mg) had a 2.64 (95 % CI 1.03-6.74) times higher risk of one year and a 2.11 (95 % CI 1.13-3.96) times higher risk of five year revision. CONCLUSIONS: Opioid use 91–180 days post-surgery is associated with higher risk of revision surgery and therefore is an early and useful indicator for surgical failure. BioMed Central 2016-03-10 /pmc/articles/PMC4785728/ /pubmed/26965992 http://dx.doi.org/10.1186/s12891-016-0970-6 Text en © Inacio et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Inacio, Maria C. S. Pratt, Nicole L. Roughead, Elizabeth E. Paxton, Elizabeth W. Graves, Stephen E. Opioid use after total hip arthroplasty surgery is associated with revision surgery |
title | Opioid use after total hip arthroplasty surgery is associated with revision surgery |
title_full | Opioid use after total hip arthroplasty surgery is associated with revision surgery |
title_fullStr | Opioid use after total hip arthroplasty surgery is associated with revision surgery |
title_full_unstemmed | Opioid use after total hip arthroplasty surgery is associated with revision surgery |
title_short | Opioid use after total hip arthroplasty surgery is associated with revision surgery |
title_sort | opioid use after total hip arthroplasty surgery is associated with revision surgery |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785728/ https://www.ncbi.nlm.nih.gov/pubmed/26965992 http://dx.doi.org/10.1186/s12891-016-0970-6 |
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