BACKGROUND: Little is known regarding the rates and risk factors for long-term postoperative opioid use among opioid-naïve patients undergoing elective shoulder surgery. PURPOSE: To identify (1) the proportion of opioid-naïve patients undergoing elective shoulder surgery, (2) the rates of postoperative opioid use among these patients, and (3) the risk factors associated with long-term postoperative opioid use. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A retrospective review of a private administrative claims database was performed to identify those individuals who underwent elective shoulder surgery between 2007 and 2015. "Opioid-naïve" patients were identified as those patients who had not filled an opioid prescription in the 180 days before the index surgery. Within this subgroup, we tracked postoperative opioid prescription refill rates and used a logistic regression to identify patient variables that were predictive for long-term opioid use, which we defined as continued opioid refills beyond 180 days after surgery. Results were reported as odds ratios (ORs). RESULTS: Over the study period, 79,287 patients were identified who underwent elective shoulder surgery, of whom 79.5% were opioid naïve. Among opioid-naïve patients, the rate of postoperative opioid use declined over time, and 14.6% of patients were still using opioids beyond 180 days. The greatest proportion of opioid-naïve patients still filling opioid prescriptions beyond 180 days postoperatively was seen after open rotator cuff repair (20.9%), whereas arthroscopic labral repair had the lowest proportion (9.8%). Overall, a history of alcohol abuse (OR 1.56), a history of depression (OR 1.46), a history of anxiety (OR, 1.31), female sex (OR, 1.11), and higher Charlson Comorbidity Index (OR 1.02) had the most significant influence on the risk for long-term opioid use among opioid naïve patients. CONCLUSIONS: Most patients were opioid naïve before elective shoulder surgery; however, among opioid-naïve patients, 1 in 7 patients were still using opioids beyond 180 days after surgery. Among all variables, a history of mental illness most significantly increased the risk of long-term opioid use after elective shoulder surgery.
BACKGROUND: Little is known regarding the rates and risk factors for long-term postoperative opioid use among opioid-naïve patients undergoing elective shoulder surgery. PURPOSE: To identify (1) the proportion of opioid-naïve patients undergoing elective shoulder surgery, (2) the rates of postoperative opioid use among these patients, and (3) the risk factors associated with long-term postoperative opioid use. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A retrospective review of a private administrative claims database was performed to identify those individuals who underwent elective shoulder surgery between 2007 and 2015. "Opioid-naïve" patients were identified as those patients who had not filled an opioid prescription in the 180 days before the index surgery. Within this subgroup, we tracked postoperative opioid prescription refill rates and used a logistic regression to identify patient variables that were predictive for long-term opioid use, which we defined as continued opioid refills beyond 180 days after surgery. Results were reported as odds ratios (ORs). RESULTS: Over the study period, 79,287 patients were identified who underwent elective shoulder surgery, of whom 79.5% were opioid naïve. Among opioid-naïve patients, the rate of postoperative opioid use declined over time, and 14.6% of patients were still using opioids beyond 180 days. The greatest proportion of opioid-naïve patients still filling opioid prescriptions beyond 180 days postoperatively was seen after open rotator cuff repair (20.9%), whereas arthroscopic labral repair had the lowest proportion (9.8%). Overall, a history of alcohol abuse (OR 1.56), a history of depression (OR 1.46), a history of anxiety (OR, 1.31), female sex (OR, 1.11), and higher Charlson Comorbidity Index (OR 1.02) had the most significant influence on the risk for long-term opioid use among opioid naïve patients. CONCLUSIONS: Most patients were opioid naïve before elective shoulder surgery; however, among opioid-naïve patients, 1 in 7 patients were still using opioids beyond 180 days after surgery. Among all variables, a history of mental illness most significantly increased the risk of long-term opioid use after elective shoulder surgery.
Authors: Samuel J Swiggett; Matthew L Ciminero; Miriam D Weisberg; Rushabh M Vakharia; Ramin Sadeghpour; Jack Choueka Journal: Shoulder Elbow Date: 2021-03-02
Authors: Michael R Mercier; Anoop R Galivanche; Anthony J Wiggins; Joseph B Kahan; William McLaughlin; Zachary J Radford; Jonathan N Grauer; Elizabeth C Gardner Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2022-07-11
Authors: Vidushan Nadarajah; Sean J Meredith; Julio J Jauregui; Michael P Smuda; Shaun Medina; Mohit N Gilotra; S Ashfaq Hasan; R Frank Henn Journal: Shoulder Elbow Date: 2019-10-17
Authors: Nicholas A Trasolini; Ioanna K Bolia; Hyunwoo P Kang; Anthony Essilfie; Erik N Mayer; Reza Omid; Seth C Gamradt; George F Hatch; Alexander E Weber Journal: Orthop J Sports Med Date: 2020-06-23
Authors: Sambit Sahoo; Kathleen A Derwin; Alexander Zajichek; Vahid Entezari; Peter B Imrey; Joseph P Iannotti; Eric T Ricchetti Journal: J Shoulder Elbow Surg Date: 2020-08-26 Impact factor: 3.019
Authors: Corey C Spencer; Jeremiah A Pflederer; Jacob M Wilson; Alexander M Dawes; Michael B Gottschalk; Eric R Wagner Journal: JSES Int Date: 2021-04-03