Evidence map›Paper›PMID 34846586›Full record

ArticleArchives of orthopaedic and trauma surgery2022

Predictors of continued opioid use 6 months after total joint arthroplasty: a multi-site study.

Nicholas A Giordano, Krista B Highland, Vi Nghiem, Maya Scott-Richardson, Michael Kent

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In one paragraph

Article in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
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

4 citing papers in PubMed, 8 citations in OpenAlex.

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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

5 authors at 4 institutions in 1 country.

Nicholas A GiordanoNell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, USA. ngiorda@emory.edu.ORCID https://orcid.org/0000-0003-0112-6214
Krista B HighlandDefense and Veterans Center for Integrative Pain Management, Uniformed Services University, 11300 Rockville Pike, Rockville, MD, 20852, USA.
Vi NghiemDefense and Veterans Center for Integrative Pain Management, Uniformed Services University, 11300 Rockville Pike, Rockville, MD, 20852, USA.
Maya Scott-RichardsonDefense and Veterans Center for Integrative Pain Management, Uniformed Services University, 11300 Rockville Pike, Rockville, MD, 20852, USA.
Michael KentDepartment of Anesthesiology, Duke University School of Medicine, 134 Research Drive, Durham, NC, 27710, USA.
Henry M. Jackson Foundation · USDuke University · USEmory University · USGrant Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeContinued opioid use after total knee and hip arthroplasty (TKA/THA) is well-documented and associated with both surgical and patient-reported factors. Research examining the combined effects of a multitude of factors on continued, and even chronic, opioid use in a systematic algorithmic manner is lacking. This study prospectively evaluated the combined effect of patient-related and surgical factors associated with continued opioid use after TKA/THA.

methodsFrom 2016 to 2018, 198 participants undergoing TKA or THA were recruited from two tertiary care facilities. Participants completed surveys before surgery and at 2 weeks, 1, 3, and 6 months following surgery. A LASSO approach, followed by an exhaustive covariate selection procedure, was used to build a multivariable mixed-effects logistic regression model estimating the odds ratio of continued postoperative opioid use based on surgical factors and patient-reported factors.

resultsApproximately half of the participants underwent either TKA (49%) or THA (51%). Preoperatively, 15% of participants reported taking opioid medication. Opioid use decreased from 68% at 2-week follow-up to 7% by 6 months. In addition, preoperative opioid use (95% CI 1.07-4.37), increased pain (95% CI 1.21-1.62), elevated preoperative Pain Catastrophizing Scale scores (95% CI 1.01-1.04), lower Physical Function scores (95% CI 0.87-0.95), and participants undergoing TKA, compared to THA, (95% CI 0.25-0.67) were found to be significantly associated with continued postoperative opioid use up to 6 months.

conclusionPreoperative opioid use, average pain, reduced physical function, and TKA were significantly associated with continued postoperative opioid use. Findings illustrate the need for preoperative and longitudinal assessment of patient-reported outcomes to mitigate poor postoperative pain outcomes. LEVEL OF EVIDENCE: II.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeOpioid-Related DisordersAnalgesics, OpioidHumansKnee JointPostoperative PainAnalgesics, OpioidOpioidPainPostoperative painTotal hip arthroplastyTotal knee arthroplasty

Identifiers

PMID34846586
OpenAlexW3215591865

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Registered trials

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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.