Risk factors for postoperative opioid use after elective shoulder arthroplasty

• Published in: Journal of shoulder and elbow surgery 2018-11, Vol.27 (11), p.1960-1968
• Main Authors: Rao, Anita G., Chan, Priscilla H., Prentice, Heather A., Paxton, Elizabeth W., Navarro, Ronald A., Dillon, Mark T., Singh, Anshuman
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analgesics, Opioid - therapeutic use; arthroplasty; Arthroplasty - adverse effects; elective surgery; Elective Surgical Procedures - adverse effects; Female; Humans; Male; Middle Aged; opioid; pain; Pain, Postoperative - diagnosis; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; postoperative; Retrospective Studies; risk factor; Risk Factors; Shoulder; Shoulder Joint - surgery; United States
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2018.04.018

The opioid epidemic remains a serious issue in the United States with significant impact to the medical and socioeconomic welfare of communities. We sought to determine baseline opioid use in patients undergoing shoulder arthroplasty (SA) and identify patient characteristics, comorbidities, and surgical risk factors associated with postoperative opioid use. A Shoulder Arthroplasty Registry identified the number of dispensed opioid medication prescriptions (Rxs) in the first postoperative year in patients who underwent elective primary SA from 2008 to 2014. We used Poisson regression to study the effect of preoperative risks factors on number of dispensed opioid Rxs in the first postoperative year, evaluated quarterly (Q1: days 0-90, Q2: days 91-180, Q3: days 181-270, Q4: days 271-360). Included were 4243 SAs from 3996 patients, and 75% used opioids in the 1-year preoperative period. The factors associated with increased opioid use in all postoperative quarters (Q4 incident rate ratio [IRR] shown) were age