ArticlePain medicine (Malden, Mass.)2025
Identifying factors associated with persistent opioid use after total joint arthroplasty: a retrospective review.
Article in Pain medicine (Malden, Mass.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Development and Internal Validation of a Machine Learning Model for Predicting Long-Term Opioid Therapy After Hip Fracture Surgery in Older, Opioid-Naïve Adults.European journal of pain (London, England) · 2026Article
- Ethical Dilemmas and Approaches to Acute Pain Management in Patients With Substance Use Disorders.Cureus · 2025Review
- Association of Socioeconomic and Psychiatric Factors with Postoperative Opioid Use Disorder: A Retrospective Cohort Analysis.Substance use : research and treatmentArticle
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8 authors.
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Abstract
objectiveTo identify predictors of persistent opioid use in opioid-naïve individuals undergoing total joint arthroplasty.
designRetrospective cohort study.
settingMaine Health System. SUBJECTS: Opioid-naïve patients who underwent at least one total joint arthroplasty (knee, hip, or shoulder) between 2015 and 2020.
methodsLeast Absolute Shrinkage and Selection Operator (LASSO) logistic regression was used to create a predictive model for persistent opioid use after surgery from a US Electronic Health Record dataset in the Observational Medical Outcomes Partnership Common Data Model format. 75% of the data was used to build the LASSO model using 10-fold cross-validation and 25% of the data was used to determine the optimal probability threshold for predicting the binary outcome.
resultsOut of 6432 patients, 12.3% (792) were identified as having persistent opioid use across combined total joint arthroplasties defined as at least one opioid prescription between 90 days and 1 year after surgery. Patients with persistent opioid use were more likely to be current smokers (OR 1.65), use antidepressants (OR 1.76), or have a diagnosis of post-traumatic stress disorder (OR 2.07) or a substance-related disorder (OR 1.69). Other factors associated with persistent opioid use included back pain (OR 1.43), dementia (OR 1.65), and body mass index over 40 (OR 2.50). The probability of persistent opioid use was not associated with age, sex, or ethnicity.
conclusionsThis predictive model for persistent opioid use after total joint arthroplasty shows promise as an evidence-based, validated, and standardized tool for identifying high-risk patients before surgery in order to target strategies and interventions to reduce the reliance on opioids for postoperative pain control.
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