Evidence map›Paper›PMID 30963325›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2019

Increased opioid consumption in diabetics with operative ankle fractures: a retrospective case-control study.

David A Weiner, Jordan P Murphy, Chukwuweike Gwam, Galvin J Loughran, Christian Vulpis, David P Milzman, Jacob M Wisbeck

Abstract read
PubMed Publisher
In one paragraph

Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Observational
  4. Observational
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

David A WeinerDepartment of Orthopedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA. dave.a.weiner@gmail.com.
Jordan P MurphyGeorgetown University School of Medicine, Washington, DC, USA.ORCID http://orcid.org/0000-0002-4680-0690
Chukwuweike GwamDepartment of Orthopedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Galvin J LoughranGeorgetown University School of Medicine, Washington, DC, USA.
Christian VulpisGeorgetown University School of Medicine, Washington, DC, USA.
David P MilzmanGeorgetown University School of Medicine, Washington, DC, USA.
Jacob M WisbeckDepartment of Orthopedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOpioids are commonly used for post-operative pain control. It is known that diabetic patients with ankle fractures will experience prolonged healing, higher risk of hardware failure, and an increased risk of infection. However, the opioid requirements amongst this patient cohort have not been previously evaluated. Thus, the purpose of this study is to retrospectively compare opioid utilization amongst ankle fracture patients with and without diabetes mellitus (DM).

methodsAn IRB approval was obtained for the retrospective review of patients who presented with an ankle fracture and underwent surgery between November 2013 and January 2017. A total of 180 patients (144 without DM, 36 with DM) with a mean age of 50 years (± 18 years) were included. Opioid consumption was quantified utilizing a morphine-milliequivalent conversion algorithm. A repeated measures ANOVA was conducted to compare opioid consumption. A two-tailed p value of 0.05 was set as the threshold for statistical significance.

resultsRepeated measures ANOVA revealed a statistically significant decrease in total opioid consumption during the 4-month duration (p < 0.001). The model demonstrated a mean difference in opioid consumption of - 214.3 morphine meq between the patients without and with DM (p = 0.022). Post hoc pair-wise comparison revealed less opioid consumption amongst non-diabetic patients at 2 (- 418.5 Meq; p = 0.009), 3 months (- 355.6 Meq; p = 0.021), and 4 months (- 152.6 Meq; p = 0.006) after surgery.

conclusionOur study revealed increased opioid consumption amongst diabetic patients who are treated surgically for ankle fractures. With increasing efforts aimed at reducing opioid administration, orthopaedic surgeons should be aware of higher opioid consumption amongst this patient cohort. Further studies are needed to verify the results of this study.

Indexed as

Analgesics, OpioidPostoperative ComplicationsAnkle FracturesComorbidityDiabetes MellitusDrug Utilization ReviewFemaleFracture FixationHumansMaleMiddle AgedPain ManagementPostoperative PainPrescription Drug OveruseRetrospective StudiesAnalgesics, OpioidAnkle fracturesDiabetesNarcoticsOpioids

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.