Does the type of lower extremity fracture affect long-term opioid usage? A meta-analysis
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..
INTRODUCTION: Patients recovering from musculoskeletal trauma have a heightened risk of opioid dependence and misuse, as these medications are typically required for pain management. The purpose of this meta-analysis was to examine the association between fracture type and chronic opioid use following fracture fixation in patients who sustain lower extremity trauma.
MATERIALS AND METHODS: A meta-analysis was performed using PubMed and Web of Science to identify articles reporting chronic opioid use in patients recovering from surgery for lower extremity fractures. 732 articles were identified using keyword and MeSH search functions, and 9 met selection criteria. Studies were included in the final analysis if they reported the number of patients who remained on opioids 6 months after surgery for a specific lower extremity fracture (chronic usage). Logistic regressions and descriptive analyses were performed to determine the rate of chronic opioid use within each fracture type and if age, year, country of origin of study, or pre-admission opioid use influenced chronic opioid use following surgery.
RESULTS: Bicondylar and unicondylar tibial-plateau fractures had the largest percentage of patients that become chronic opioid users (29.7-35.2%), followed by hip (27.8%), ankle (19.7%), femoral-shaft (18.5%), pilon (17.2%), tibial-shaft (13.8%), and simple ankle fractures (2.8-4.7%).Most opioid-naive samples had significantly lower rates of chronic opioid use after surgery (2-9%, 95% CI) when compared to samples that allowed pre-admission opioid use (13-50%, 95% CI). There were no significant associations between post-operative chronic opioid use and age, year, or country of origin of study.
CONCLUSIONS: Patients with lower extremity fractures have substantial risk of becoming chronic opioid users. Even the lowest rates of chronic opioid use identified in this meta-analysis are higher than those in the general population. It is important that orthopedic surgeons tailor pain-management protocols to decrease opioid usage after lower extremity trauma.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:144 |
|---|---|
| Enthalten in: |
Archives of orthopaedic and trauma surgery - 144(2024), 3 vom: 01. Feb., Seite 1221-1231 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Otwell, Alexandra G [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Analgesics, Opioid |
|---|
| Anmerkungen: |
Date Completed 28.02.2024 Date Revised 28.02.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00402-023-05174-5 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368561003 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368561003 | ||
| 003 | DE-627 | ||
| 005 | 20240229171041.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240217s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00402-023-05174-5 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1310.xml |
| 035 | |a (DE-627)NLM368561003 | ||
| 035 | |a (NLM)38366036 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Otwell, Alexandra G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Does the type of lower extremity fracture affect long-term opioid usage? A meta-analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 28.02.2024 | ||
| 500 | |a Date Revised 28.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. | ||
| 520 | |a INTRODUCTION: Patients recovering from musculoskeletal trauma have a heightened risk of opioid dependence and misuse, as these medications are typically required for pain management. The purpose of this meta-analysis was to examine the association between fracture type and chronic opioid use following fracture fixation in patients who sustain lower extremity trauma | ||
| 520 | |a MATERIALS AND METHODS: A meta-analysis was performed using PubMed and Web of Science to identify articles reporting chronic opioid use in patients recovering from surgery for lower extremity fractures. 732 articles were identified using keyword and MeSH search functions, and 9 met selection criteria. Studies were included in the final analysis if they reported the number of patients who remained on opioids 6 months after surgery for a specific lower extremity fracture (chronic usage). Logistic regressions and descriptive analyses were performed to determine the rate of chronic opioid use within each fracture type and if age, year, country of origin of study, or pre-admission opioid use influenced chronic opioid use following surgery | ||
| 520 | |a RESULTS: Bicondylar and unicondylar tibial-plateau fractures had the largest percentage of patients that become chronic opioid users (29.7-35.2%), followed by hip (27.8%), ankle (19.7%), femoral-shaft (18.5%), pilon (17.2%), tibial-shaft (13.8%), and simple ankle fractures (2.8-4.7%).Most opioid-naive samples had significantly lower rates of chronic opioid use after surgery (2-9%, 95% CI) when compared to samples that allowed pre-admission opioid use (13-50%, 95% CI). There were no significant associations between post-operative chronic opioid use and age, year, or country of origin of study | ||
| 520 | |a CONCLUSIONS: Patients with lower extremity fractures have substantial risk of becoming chronic opioid users. Even the lowest rates of chronic opioid use identified in this meta-analysis are higher than those in the general population. It is important that orthopedic surgeons tailor pain-management protocols to decrease opioid usage after lower extremity trauma | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Long-bone fracture | |
| 650 | 4 | |a Lower extremity fracture | |
| 650 | 4 | |a Meta-analysis | |
| 650 | 4 | |a Narcotics | |
| 650 | 4 | |a Opioid use | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 700 | 1 | |a Stambough, Jeffrey B |e verfasserin |4 aut | |
| 700 | 1 | |a Cherney, Steven M |e verfasserin |4 aut | |
| 700 | 1 | |a Blake, Lindsay |e verfasserin |4 aut | |
| 700 | 1 | |a Siegel, Eric R |e verfasserin |4 aut | |
| 700 | 1 | |a Mears, Simon C |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Archives of orthopaedic and trauma surgery |d 1996 |g 144(2024), 3 vom: 01. Feb., Seite 1221-1231 |w (DE-627)NLM01295120X |x 1434-3916 |7 nnns |
| 773 | 1 | 8 | |g volume:144 |g year:2024 |g number:3 |g day:01 |g month:02 |g pages:1221-1231 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00402-023-05174-5 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 144 |j 2024 |e 3 |b 01 |c 02 |h 1221-1231 | ||