Evidence map›Paper›PMID 35314993›Full record

ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2022

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

Ana Johnson, Brian Milne, Narges Jamali, Matthew Pasquali, Ian Gilron, Steve Mann, Kieran Moore, Erin Graves, Joel Parlow

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In one paragraph

Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 16% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
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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

9 authors at 3 institutions in 1 country.

Ana JohnsonDepartment of Public Health Sciences, Senior ICES Scientist, Queen's University, Kingston, ON, Canada.
Brian MilneDepartment of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Narges JamaliQueen's University, Kingston, ON, Canada.
Matthew PasqualiQueen's University, Kingston, ON, Canada.
Ian GilronDepartment of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
Steve MannDivision of Orthopedic Surgery, Queen's University, Kingston, ON, Canada.
Kieran MooreDepartments of Emergency and Family Medicine, Queen's University, Kingston, ON, Canada.
Erin GravesInstitute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Joel ParlowDepartment of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Queen's University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada. parlowj@queensu.ca.ORCID http://orcid.org/0000-0002-4461-5934
Queen's University · CAInstitute for Clinical Evaluative Sciences · CAWestern University · CA

Funding

Institute for Clinical Evaluative Sciences AHRQ
6 · The paper itself

Abstract

purposePostoperative 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.

methodsWe 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.

resultsThe 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.

conclusionChronic 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.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneeOpioid-Related DisordersAnalgesics, OpioidCohort StudiesHumansPatient Acceptance of Health CarePostoperative PainRetrospective StudiesAnalgesics, Opioidanalgesicsarthroplastyeconomicsopioidspostoperative pain

Identifiers

PMID35314993
OpenAlexW4220798897

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.