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Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 8/2022

22.03.2022 | Reports of Original Investigations

Chronic opioid use after joint replacement surgery in seniors is associated with increased healthcare utilization and costs: a historical cohort study

verfasst von: Ana Johnson, PhD, Brian Milne, MD, FRCPC, Narges Jamali, BSc, Matthew Pasquali, MSc, Ian Gilron, MD, FRCPC, Steve Mann, MD, FRCSC, Kieran Moore, MD, FRCPC, Erin Graves, MSc, Joel Parlow, MD, FRCPC

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 8/2022

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Abstract

Purpose

Postoperative opioid use may be associated with increased healthcare utilization and costs. We sought to examine the relationship between duration of postoperative opioid prescriptions and healthcare costs and resource utilization in senior patients following hip and knee replacement.

Methods

We conducted a historical cohort study evaluating postoperative opioid use and healthcare costs in patients over the age of 65 yr undergoing primary total hip or knee arthroplasty over a ten-year period from 1 April 2006 to 31 March 2016. The last follow-up date was 31 March 2017. We identified preoperative and postoperative opioid prescriptions, patient characteristics, and healthcare costs using deidentified Ontario administrative databases (Institute of Clinical Evaluative Sciences). Duration of postoperative opioid use was divided into four categories: short-term (1–90 days), prolonged (91–180 days), chronic (181–365 days), and undocumented.

Results

The study included 49,638 hip and 85,558 knee replacement patients. Although the initial hospitalization accounted for the greatest cost in all patients, over the following year patients in the short-term opioid use group incurred the lowest average costs, and those in the chronic group incurred the highest (hip, CAD 17,528 vs CAD 26,736; knee, CAD 16,043 vs CAD 23,007), driven by increased healthcare resource utilization.

Conclusion

Chronic opioid use after arthroplasty was associated with higher resource utilization and healthcare costs during the year following surgery. These results can be used to develop predictors of longer opioid use and higher costs. Further research is planned to determine whether recently implemented opioid reduction strategies can reduce healthcare resource utilization.
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Metadaten
Titel
Chronic opioid use after joint replacement surgery in seniors is associated with increased healthcare utilization and costs: a historical cohort study
verfasst von
Ana Johnson, PhD
Brian Milne, MD, FRCPC
Narges Jamali, BSc
Matthew Pasquali, MSc
Ian Gilron, MD, FRCPC
Steve Mann, MD, FRCSC
Kieran Moore, MD, FRCPC
Erin Graves, MSc
Joel Parlow, MD, FRCPC
Publikationsdatum
22.03.2022
Verlag
Springer International Publishing
Erschienen in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 8/2022
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-022-02240-1

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