Assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study

BACKGROUND: Prescribing habits during admission have largely contributed to the opioid epidemic. Orthopedic surgeons represent the third-highest opioid-prescribing specialty. Since more than half of body fractures in Saudi Arabia have been lower extremity fractures, it is imperative to understand op...

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Autores principales: Ramadan, Majed, Alnashri, Yahya, Ilyas, Amjad, Batouk, Omar, Alsheikh, Khalid A., Alhelabi, Laila, Alnashri, Suliman Abdulah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: King Faisal Specialist Hospital and Research Centre 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706711/
https://www.ncbi.nlm.nih.gov/pubmed/36444923
http://dx.doi.org/10.5144/0256-4947.2022.366
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author Ramadan, Majed
Alnashri, Yahya
Ilyas, Amjad
Batouk, Omar
Alsheikh, Khalid A.
Alhelabi, Laila
Alnashri, Suliman Abdulah
author_facet Ramadan, Majed
Alnashri, Yahya
Ilyas, Amjad
Batouk, Omar
Alsheikh, Khalid A.
Alhelabi, Laila
Alnashri, Suliman Abdulah
author_sort Ramadan, Majed
collection PubMed
description BACKGROUND: Prescribing habits during admission have largely contributed to the opioid epidemic. Orthopedic surgeons represent the third-highest opioid-prescribing specialty. Since more than half of body fractures in Saudi Arabia have been lower extremity fractures, it is imperative to understand opioid administration patterns and correlates among opioid-naïve inpatients. OBJECTIVES: Assess opioid administration patterns and correlates among opioid-naïve inpatients with lower extremity fractures. DESIGN AND SETTINGS: Retrospective cohort PATIENTS AND METHODS: Opioid naïve individuals aged 18 to 64 years, admitted due to lower extremity fracture from 2016 to 2020 were included. Data was collected from health records of the Ministry of National Guard Health Affairs (MNG-HA) at five different medical centers. The high-dose (≥50 MME) patients were compared with low dose (<50 MME) patients. Any association between inpatient factors and high-dose opioid use was analyzed by multiple logistic regression. MAIN OUTCOME MEASURES: Opioids taken during inpatient admission as measured by milligram morphine equivalents (MME)/per day. SAMPLE SIZE: 1520 patients RESULTS: Most of the 1520 patients (88.5%) received an opioid medication, while (20.3%) received high-dose opioids at a median daily dose of 33.7 MME/per day. The proportion of patients received naloxone (20.7%) was double among high-dose opioid inpatients. High-dose opioid patients during admission were two times more likely to receive an opioid prescription after discharge (odds ratio, 2.32; 95% confidence interval, 1.53, 3.51), and three more times likely to receive ketamine during admission (odds ratio, 3.02; 95% confidence interval, 1.64, 5.54). CONCLUSION: Notable variabilities exist in opioid administration patterns that were not explained by patient factors. Evidence-based opioid prescribing practices should be developed for orthopedic patients to prevent opioid overprescribing and potential opioid overdose among orthopedic patients. LIMITATIONS: Retrospective, unmeasurable confounders might have biased our results. Since based on National Guard employees, results may not be generalizable. CONFLICT OF INTEREST: None.
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spelling pubmed-97067112022-12-12 Assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study Ramadan, Majed Alnashri, Yahya Ilyas, Amjad Batouk, Omar Alsheikh, Khalid A. Alhelabi, Laila Alnashri, Suliman Abdulah Ann Saudi Med Original Article BACKGROUND: Prescribing habits during admission have largely contributed to the opioid epidemic. Orthopedic surgeons represent the third-highest opioid-prescribing specialty. Since more than half of body fractures in Saudi Arabia have been lower extremity fractures, it is imperative to understand opioid administration patterns and correlates among opioid-naïve inpatients. OBJECTIVES: Assess opioid administration patterns and correlates among opioid-naïve inpatients with lower extremity fractures. DESIGN AND SETTINGS: Retrospective cohort PATIENTS AND METHODS: Opioid naïve individuals aged 18 to 64 years, admitted due to lower extremity fracture from 2016 to 2020 were included. Data was collected from health records of the Ministry of National Guard Health Affairs (MNG-HA) at five different medical centers. The high-dose (≥50 MME) patients were compared with low dose (<50 MME) patients. Any association between inpatient factors and high-dose opioid use was analyzed by multiple logistic regression. MAIN OUTCOME MEASURES: Opioids taken during inpatient admission as measured by milligram morphine equivalents (MME)/per day. SAMPLE SIZE: 1520 patients RESULTS: Most of the 1520 patients (88.5%) received an opioid medication, while (20.3%) received high-dose opioids at a median daily dose of 33.7 MME/per day. The proportion of patients received naloxone (20.7%) was double among high-dose opioid inpatients. High-dose opioid patients during admission were two times more likely to receive an opioid prescription after discharge (odds ratio, 2.32; 95% confidence interval, 1.53, 3.51), and three more times likely to receive ketamine during admission (odds ratio, 3.02; 95% confidence interval, 1.64, 5.54). CONCLUSION: Notable variabilities exist in opioid administration patterns that were not explained by patient factors. Evidence-based opioid prescribing practices should be developed for orthopedic patients to prevent opioid overprescribing and potential opioid overdose among orthopedic patients. LIMITATIONS: Retrospective, unmeasurable confounders might have biased our results. Since based on National Guard employees, results may not be generalizable. CONFLICT OF INTEREST: None. King Faisal Specialist Hospital and Research Centre 2022-11 2022-12-01 /pmc/articles/PMC9706711/ /pubmed/36444923 http://dx.doi.org/10.5144/0256-4947.2022.366 Text en Copyright © 2022, Annals of Saudi Medicine, Saudi Arabia https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). The details of which can be accessed at http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Article
Ramadan, Majed
Alnashri, Yahya
Ilyas, Amjad
Batouk, Omar
Alsheikh, Khalid A.
Alhelabi, Laila
Alnashri, Suliman Abdulah
Assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study
title Assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study
title_full Assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study
title_fullStr Assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study
title_full_unstemmed Assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study
title_short Assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study
title_sort assessment of opioid administration patterns following lower extremity fracture among opioid-naïve inpatients: retrospective multicenter cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706711/
https://www.ncbi.nlm.nih.gov/pubmed/36444923
http://dx.doi.org/10.5144/0256-4947.2022.366
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