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. 2023 Nov 17;7(11):e23.00118.
doi: 10.5435/JAAOSGlobal-D-23-00118. eCollection 2023 Nov 1.

Risk Factors Associated With Prolonged Opioid Use After Revision Total Shoulder Arthroplasty

Varag Abed  1 , Camille D Khalily, David C Landy, Nicole G Lemaster, Austin V Stone
Affiliations

Risk Factors Associated With Prolonged Opioid Use After Revision Total Shoulder Arthroplasty

Varag Abed et al. J Am Acad Orthop Surg Glob Res Rev. .

Abstract

Introduction: The purpose of this study was to determine which preoperative factors are associated with prolonged opioid use after revision total shoulder arthroplasty (TSA).

Methods: The M157Ortho PearlDiver database was used to identify patients undergoing revision TSA between 2010 and 2021. Opioid use for longer than 1 month after surgery was defined as prolonged opioid use. Postoperative opioid use from 1 to 3 months was independently assessed. Multivariable logistic regression was used to evaluate the association between preoperative patient-related risk factors (age, Charlson Comorbidity Index, sex, depression, anxiety, substance use disorder, opioid use between 12 months to 1 week of surgery, tobacco use, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, osteoporosis, previous myocardial infarction, and chronic ischemic heart disease) with prolonged postoperative opioid use. Odds ratios (OR) and their associated 95% confidence intervals (CI) were calculated for each risk factor.

Results: A total 14,887 patients (mean age = 67.1 years) were included. Most of the patients were female (53.3%), and a large proportion were opioid familiar (44.1%). Three months after revision TSA, older age (OR = 0.96, CI 0.96 to 0.97) and male sex (OR = 0.90, CI 0.81 to 0.99) were associated with a decreased risk of prolonged postoperative opioid usage. Patients with preexisting depression (OR = 1.21, CI 1.08 to 1.35), substance use disorder (OR = 1.47, CI 1.29 to 1.68), opioid use (OR = 16.25, CI 14.27 to 18.57), and chronic obstructive pulmonary disorder (OR = 1.24, CI 1.07 to 1.42) were at an increased risk of prolonged postoperative opioid use.

Discussion: Older age and male sex were associated with a decreased risk of prolonged opioid use after revision TSA. Depression, substance use disorder, opioid familiarity, and COPD were associated with prolonged opioid use after revision TSA.

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Figures

Figure 1
Figure 1
Graph showing percentage of patients using opioids. Blue line represents the percentage of opioid-familiar patients who continued using opioids up to 3 months postoperatively Orange line represents the percentage of opioid-naïve patients who continued using opioids up to 3 months postoperatively.
See this image and copyright information in PMC

References

    1. Lyden J, Binswanger IA: The United States opioid epidemic. Semin Perinatol 2019;43:123-131. - PMC - PubMed
    1. Castle JP, Jildeh TR, Buckley PJ, Abbas MJ, Mumuni S, Okoroha KR: Older, heavier, arthritic, psychiatrically disordered, and opioid-familiar patients are at risk for opioid use after medial patellofemoral ligament reconstruction. Arthrosc Sports Med Rehabil 2021;3:e2025-e2031. - PMC - PubMed
    1. Morris BJ, Mir HR: The opioid epidemic: Impact on orthopaedic surgery. J Am Acad Orthop Surg 2015;23:267-271. - PubMed
    1. Rao AG, Chan PH, Prentice HA, Paxton EW, Funahashi TT, Maletis GB: Risk factors for opioid use after anterior cruciate ligament reconstruction. Am J Sports Med 2019;47:2130-2137. - PubMed
    1. Jildeh TR, Taylor KA, Khalil LS, et al. : Risk factors for postoperative opioid use in arthroscopic meniscal surgery. Arthroscopy 2019;35:575-580. - PubMed

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