The Impact of Mental Health and Substance Use on Opioid Demand After Hip Fracture Surgery.

The Journal of the American Academy of Orthopaedic Surgeons
Daniel J CunninghamMark J Gage

Abstract

Mental health and substance use and abuse disorders have been associated with poor patient-reported outcomes. Despite the prevalence of hip fractures in the United States, the relationship between opioid demand and these factors in hip fracture surgery is not well understood. The purpose of this study is to describe opioid filling volume and rates after hip fracture surgery and to identify mental health risk factors for increased demand. The study hypothesis is that psychiatric comorbidities such as depression and psychoses as well as substance use and abuse indicators such as pre-op opioid dependence, drug, alcohol, and tobacco abuse would be associated with increased perioperative opioid demand. This is a retrospective cohort study of 40,514 patients undergoing surgical fixation of hip fractures using a commercially available insurance database. The primary patient-level outcome was filled opioid prescription volume in oral morphine milliequivalents converted to oxycodone 5-mg equivalents up to 1-year post-op. Adjusted measures of overall quantities filled and refill rates were assessed with multivariable main effects linear and logistic regression models. Twenty four thousand four hundred forty-one of 40,514 patients (60.3%)...Continue Reading

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Citations

May 4, 2021·Archives of Orthopaedic and Trauma Surgery·Daniel J CunninghamMark J Gage
Sep 15, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Daniel J CunninghamMark J Gage

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