Preoperative opioid use disorder has a negative impact on the rate of short-term complications following total and reverse shoulder replacement

More than 2 million Americans and 16 million individuals worldwide are estimated to have an opioid use disorder (OUD). It is imperative that we understand the impact OUD has on patients who require surgical procedures. Preoperative OUD has been associated with increased postoperative complications,...

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Bibliographic Details
Published in:Seminars in arthroplasty 2023-09, Vol.33 (3), p.547-553
Main Authors: White, Christopher A., Butler, Liam R., Quinones, Addison, Tang, Justin E., Whitelaw, Kathryn, Kantrowitz, David, Cho, Samuel K., Kim, Jun S., Cagle, Paul J.
Format: Article
Language:English
Subjects:
Complications
Length of stay
Opioid use disorder
Readmissions
Revision
Shoulder arthroplasty
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Summary:More than 2 million Americans and 16 million individuals worldwide are estimated to have an opioid use disorder (OUD). It is imperative that we understand the impact OUD has on patients who require surgical procedures. Preoperative OUD has been associated with increased postoperative complications, lengths of stay, and readmissions in elective procedures. The goal of this study was to elucidate the impact that preoperative OUD has on short-term outcomes following total and reverse shoulder arthroplasty. Patient information was collected using the National Readmissions Database (2016-2018). Persons who underwent anatomic and reverse shoulder arthroplasty were identified using International Classification of Diseases 10th Revision procedural codes (anatomic: 0RRJ0JZ/0RRK0JZ, reverse: 0RRJ00Z, 0RRK00Z). OUD was defined using the following International Classification of Diseases 10th Revision codes: F11.10, F11.11, F11.20, and F11.21. Patient demographics, comorbidity indices (Charlson and Elixhauser), complications, readmission rates, healthcare costs, and lengths of stay were compared between OUD and non-OUD patients. A univariate analysis was first run with OUD as the independent variable followed by a multivariate analysis to identify if OUD was an independent predictor of adverse outcomes. One hundred sixty four thousand and five hundred twenty two total patients were identified (OUD: 1098 vs. non-OUD: 163,424). The OUD patients were younger (64.3 ± 10.0 years vs. 69.4 ± 9.5 years, P 
ISSN:1045-4527
1558-4437
DOI:10.1053/j.sart.2023.04.008