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Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers.

Publication ,  Journal Article
Westermann, RW; Mather, RC; Bedard, NA; Anthony, CA; Glass, NA; Lynch, TS; Duchman, KR
Published in: Arthroscopy
February 2019

PURPOSE: To determine pre- and postoperative opioid utilization while identifying risk factors for prolonged postoperative opioid use following hip arthroscopy. METHODS: All patients undergoing hip arthroscopy between 2007 and the second quarter of 2016 were identified within the Humana Inc. administrative claims database. Chronic preoperative opioid utilization was defined as filling of any opioid prescription 1 to 3 months before surgery, whereas acute preoperative opioid utilization was defined as filling any opioid prescription within 1 month of surgery. Rates of pre- and postoperative opioid utilization were calculated, and patient demographic characteristics and medical conditions associated with pre- and postoperative opioid utilization were identified. RESULTS: Of the 1,208 patients undergoing hip arthroscopy, chronic and acute preoperative opioid utilization was observed in 24.9% and 17.3% of patients, respectively. Chronic preoperative opioid utilization was more frequently observed in obese (P < .001) patients, those ≥50 years of age (P = .002), and those with preexisting anxiety and/or depression (P < .001). In multivariate analysis, chronic preoperative opioid utilization was the strongest predictor of opioid prescription filling at 3, 6, 9, and 12 months postoperatively (odds ratio at 3 months, 18.60, 95% confidence interval, 12.41 to 28.55), whereas preexisting anxiety and/or depression and obesity were additionally identified as predictors of prolonged postoperative opioid utilization. CONCLUSIONS: Chronic preoperative opioid utilization before hip arthroscopy is common at 24.9%. The high rate of chronic preoperative opioid utilization is particularly important considering that chronic preoperative opioid utilization is the strongest predictor of continued postoperative opioid prescription filling out to 12 months postoperatively. LEVEL OF EVIDENCE: Level IV, retrospective case series.

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Published In

Arthroscopy

DOI

EISSN

1526-3231

Publication Date

February 2019

Volume

35

Issue

2

Start / End Page

453 / 460

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Preoperative Period
  • Postoperative Period
  • Orthopedics
  • Obesity
  • Middle Aged
  • Male
  • Humans
  • Hip Joint
 

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MLA
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Westermann, R. W., Mather, R. C., Bedard, N. A., Anthony, C. A., Glass, N. A., Lynch, T. S., & Duchman, K. R. (2019). Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers. Arthroscopy, 35(2), 453–460. https://doi.org/10.1016/j.arthro.2018.08.056
Westermann, Robert W., Richard C. Mather, Nicholas A. Bedard, Christopher A. Anthony, Natalie A. Glass, T Sean Lynch, and Kyle R. Duchman. “Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers.Arthroscopy 35, no. 2 (February 2019): 453–60. https://doi.org/10.1016/j.arthro.2018.08.056.
Westermann RW, Mather RC, Bedard NA, Anthony CA, Glass NA, Lynch TS, et al. Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers. Arthroscopy. 2019 Feb;35(2):453–60.
Westermann, Robert W., et al. “Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers.Arthroscopy, vol. 35, no. 2, Feb. 2019, pp. 453–60. Pubmed, doi:10.1016/j.arthro.2018.08.056.
Westermann RW, Mather RC, Bedard NA, Anthony CA, Glass NA, Lynch TS, Duchman KR. Prescription Opioid Use Before and After Hip Arthroscopy: A Caution to Prescribers. Arthroscopy. 2019 Feb;35(2):453–460.
Journal cover image

Published In

Arthroscopy

DOI

EISSN

1526-3231

Publication Date

February 2019

Volume

35

Issue

2

Start / End Page

453 / 460

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Preoperative Period
  • Postoperative Period
  • Orthopedics
  • Obesity
  • Middle Aged
  • Male
  • Humans
  • Hip Joint