ArticleOTA international : the open access journal of orthopaedic trauma2022
Opioid use for a first-incident upper extremity fracture in 220,440 patients without recent prior use in Ontario, Canada: a retrospective cohort study.
Article in OTA international : the open access journal of orthopaedic trauma, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 4 citations in OpenAlex.
- Article
- The Epidemiology of Lower Limb Fractures: A Major United Kingdom (UK) Trauma Centre Study.Cureus · 2024Article
- Epidemiology and Incidence of Upper Limb Fractures: A UK Level 1 Trauma Center Perspective.Cureus · 2024Article
- Does Marginalization Impact Access to Tympanostomy Tube Insertion in Pediatric Patients in Ontario?Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-facialeArticle
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To describe opioid use for a first upper extremity fracture in a cohort of patients who did not have recent opioid use. Design: Descriptive epidemiological study. Setting: Emergency Department, Hospital. Patients/Participants: We obtained health administrative data records of adults presenting with a first adult upper extremity fracture from 2013 to 2017 in Ontario, Canada. We excluded patients with previous fractures, opioid prescription in the past 6 months or hospitalization >5 days after the fracture. Intervention: Opioid prescription. Main Outcome Measurements: We identified the proportion of patients filling an opioid prescription within 7 days of fracture. We described this based on different upper extremity fractures (ICD-10), Demographics (age, sex, rurality), comorbidity (Charlson Comorbidity Index, Rheumatoid arthritis, Diabetes), season of injury, and social marginalization (Ontario Marginalization Index-a data algorithm that combines a wide range of demographic indicators into 4 distinct dimensions of marginalization). We considered statistical differences ( Results: From 220,440 patients with a first upper extremity fracture (50% female, mean age 50), opioids were used by 34% of cases overall (32% in males, 36% in females, P< .001, SMD ≥ 0.1). Use varied by body region, with those with multiple or proximal fractures having the highest use: multiple shoulder 64%, multiple regions 62%, shoulder 62%, elbow 38%, wrist 31%, and hand 21%; and was higher in patients who had a nerve/tendon injury or hospitalization (P< .01, SMD ≥ 0.1). Social marginalization, comorbidity, and season of injury had clinically insignificant effects on opioid use. Conclusions: More than one-third of patients who are recent-non-users will fill an opioid prescription within 7 days of a first upper extremity fracture, with usage highly influenced by fracture characteristics.Level of Evidence: Level II.
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