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Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients

OBJECTIVE: To explore patient and treatment factors explaining the association between spine injury and opioid misuse. DESIGN: Prospective cohort study. SETTING: Level I trauma center in a Midwestern city. PARTICIPANTS: English speaking patients aged 18 to 75 on Trauma and Orthopedic Surgical Servic...

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Autores principales: Tilhou, Alyssa Shell, Glass, Joseph E., Hetzel, Scott J., Shana, Ola Elizabeth, Borza, Tudor, Baltes, Amelia, Deyo, Bri M.F., Agarwal, Suresh, O’Rourke, Ann, Brown, Randall T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575565/
https://www.ncbi.nlm.nih.gov/pubmed/36275837
http://dx.doi.org/10.1097/OI9.0000000000000205
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author Tilhou, Alyssa Shell
Glass, Joseph E.
Hetzel, Scott J.
Shana, Ola Elizabeth
Borza, Tudor
Baltes, Amelia
Deyo, Bri M.F.
Agarwal, Suresh
O’Rourke, Ann
Brown, Randall T.
author_facet Tilhou, Alyssa Shell
Glass, Joseph E.
Hetzel, Scott J.
Shana, Ola Elizabeth
Borza, Tudor
Baltes, Amelia
Deyo, Bri M.F.
Agarwal, Suresh
O’Rourke, Ann
Brown, Randall T.
author_sort Tilhou, Alyssa Shell
collection PubMed
description OBJECTIVE: To explore patient and treatment factors explaining the association between spine injury and opioid misuse. DESIGN: Prospective cohort study. SETTING: Level I trauma center in a Midwestern city. PARTICIPANTS: English speaking patients aged 18 to 75 on Trauma and Orthopedic Surgical Services receiving opioids during hospitalization and prescribed at discharge. EXPOSURE: Spine injury on the Abbreviated Injury Scale. MAIN OUTCOME MEASURES: Opioid misuse was defined by using opioids: in a larger dose, more often, or longer than prescribed; via a non-prescribed route; from someone other than a prescriber; and/or use of heroin or opium. Exploratory factor groups included demographic, psychiatric, pain, and treatment factors. Multivariable logistic regression estimated the association between spine injury and opioid misuse when adjusting for each factor group. RESULTS: Two hundred eighty-five eligible participants consented of which 258 had baseline injury location data and 224 had follow up opioid misuse data. Most participants were male (67.8%), white (85.3%) and on average 43.1 years old. One-quarter had a spine injury (25.2%). Of those completing follow-up measures, 14 (6.3%) developed misuse. Treatment factors (injury severity, intubation, and hospital length of stay) were significantly associated with spine injury. Spine injury significantly predicted opioid misuse [odds ratio [OR] 3.20, 95% confidence interval [CI] (1.05, 9.78)]. In multivariable models, adjusting for treatment factors attenuated the association between spine injury and opioid misuse, primarily explained by length of stay. CONCLUSION: Spine injury exhibits a complex association with opioid misuse that predominantly operates through treatment factors. Spine injury patients may represent a subpopulation requiring early intervention to prevent opioid misuse.
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spelling pubmed-95755652022-10-19 Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients Tilhou, Alyssa Shell Glass, Joseph E. Hetzel, Scott J. Shana, Ola Elizabeth Borza, Tudor Baltes, Amelia Deyo, Bri M.F. Agarwal, Suresh O’Rourke, Ann Brown, Randall T. OTA Int Clinical/Basic Science Research Article OBJECTIVE: To explore patient and treatment factors explaining the association between spine injury and opioid misuse. DESIGN: Prospective cohort study. SETTING: Level I trauma center in a Midwestern city. PARTICIPANTS: English speaking patients aged 18 to 75 on Trauma and Orthopedic Surgical Services receiving opioids during hospitalization and prescribed at discharge. EXPOSURE: Spine injury on the Abbreviated Injury Scale. MAIN OUTCOME MEASURES: Opioid misuse was defined by using opioids: in a larger dose, more often, or longer than prescribed; via a non-prescribed route; from someone other than a prescriber; and/or use of heroin or opium. Exploratory factor groups included demographic, psychiatric, pain, and treatment factors. Multivariable logistic regression estimated the association between spine injury and opioid misuse when adjusting for each factor group. RESULTS: Two hundred eighty-five eligible participants consented of which 258 had baseline injury location data and 224 had follow up opioid misuse data. Most participants were male (67.8%), white (85.3%) and on average 43.1 years old. One-quarter had a spine injury (25.2%). Of those completing follow-up measures, 14 (6.3%) developed misuse. Treatment factors (injury severity, intubation, and hospital length of stay) were significantly associated with spine injury. Spine injury significantly predicted opioid misuse [odds ratio [OR] 3.20, 95% confidence interval [CI] (1.05, 9.78)]. In multivariable models, adjusting for treatment factors attenuated the association between spine injury and opioid misuse, primarily explained by length of stay. CONCLUSION: Spine injury exhibits a complex association with opioid misuse that predominantly operates through treatment factors. Spine injury patients may represent a subpopulation requiring early intervention to prevent opioid misuse. Lippincott Williams & Wilkins 2022-07-12 /pmc/articles/PMC9575565/ /pubmed/36275837 http://dx.doi.org/10.1097/OI9.0000000000000205 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Clinical/Basic Science Research Article
Tilhou, Alyssa Shell
Glass, Joseph E.
Hetzel, Scott J.
Shana, Ola Elizabeth
Borza, Tudor
Baltes, Amelia
Deyo, Bri M.F.
Agarwal, Suresh
O’Rourke, Ann
Brown, Randall T.
Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients
title Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients
title_full Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients
title_fullStr Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients
title_full_unstemmed Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients
title_short Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients
title_sort association between spine injury and opioid misuse in a prospective cohort of level i trauma patients
topic Clinical/Basic Science Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9575565/
https://www.ncbi.nlm.nih.gov/pubmed/36275837
http://dx.doi.org/10.1097/OI9.0000000000000205
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