Association between early mobilization after hip fracture surgery and risk of long-term opioid therapy.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

European Geriatric Medicine Pub Date : 2025-05-07 DOI:10.1007/s41999-025-01227-7

Yasmina Maria Tudorache, Ina Trolle Andersen, Thomas J Hjelholt, Morten Tange Kristensen, Katie J Sheehan, Alma B Pedersen

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引用次数: 0

Abstract

Aim: To examine the association between early mobilization after hip fracture surgery and the risk of long-term opioid therapy at 1-year follow-up.

Findings: Long-term opioid therapy is a common complication after hip fracture surgery. Mobilization within 24 h after surgery is associated with a lower risk of long-term opioid therapy compared to mobilization between 24 and 36 h.

Message: Early mobilization is one of the key elements of the successful patient recovery for reducing risk of complications and mortality after hip fracture surgery.

Purpose: Early mobilization after hip fracture operation is associated with better clinical outcomes, but its impact on long-term opioid therapy (LTOT) remains unclear.

Methods: Using Danish population-based registries we included patients aged ≥ 65 who underwent surgery for a first-time hip fracture between 2016 and 2021 (n = 36,229). LTOT was defined as redeeming ≥ 2 prescriptions between 31 and 365 days of surgery. Using stabilized inverse probability of treatment (sIPT) weighing, we calculated risks and risk differences with 95% confidence intervals (CI) for opioid use balancing mobilization groups ≤ 24 h vs 24-36 h on measured confounders and taking death into consideration.

Results: 67.3% of all patients were women and the median age was 82.6 years (75.8; 88.6). 75% of patients were mobilized ≤ 24 h of surgery, whereas 8% were mobilized between 24 and 36 h, 4.9% > 36 h, and 12.1% had missing data on mobilization. Patients mobilized ≤ 24 h and 24-36 h were similar in age, fracture type, and marital status, but those mobilized ≤ 24 h had fewer comorbidities, better pre-fracture mobility, and a higher social position. They also had a lower risk of LTOT (29.99%) compared to those mobilized 24-36 h (33.42%), with a weighted risk difference of 3.44% (95% CI 1.58-5.30).

Conclusions: LTOT is common after hip fracture surgery. Mobilization ≤ 24 h after surgery is associated with a lower risk of LTOT compared to mobilization between 24 and 36 h. Early mobilization is one of the key elements of successful patient recovery for reducing complications and mortality after hip fracture surgery.

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髋部骨折术后早期活动与长期阿片类药物治疗风险的关系

目的：通过1年随访，探讨髋部骨折术后早期活动与长期阿片类药物治疗风险的关系。结果：长期阿片类药物治疗是髋部骨折术后常见的并发症。与24 - 36小时的活动相比，术后24小时内的活动与长期阿片类药物治疗的风险较低相关。信息：早期活动是髋部骨折术后患者成功康复的关键因素之一，可以降低并发症和死亡率的风险。目的：髋部骨折术后早期活动与更好的临床结果相关，但其对长期阿片类药物治疗（LTOT）的影响尚不清楚。方法：使用丹麦人口为基础的登记，我们纳入了2016年至2021年间首次髋部骨折手术的年龄≥65岁的患者（n = 36229）。LTOT定义为在手术31 ~ 365天期间使用≥2个处方。使用稳定的治疗逆概率（sIPT）称重，我们计算了阿片类药物使用的风险和95%置信区间（CI），平衡了≤24 h和24-36 h的动员组在测量混杂因素上的风险和风险差异，并考虑了死亡。结果：67.3%的患者为女性，中位年龄为82.6岁(75.8；88.6)。75%的患者在手术后≤24小时活动，8%的患者在手术后24 - 36小时活动，4.9%的患者在手术后60 - 36小时活动，12.1%的患者活动数据缺失。活动≤24 h与24-36 h患者在年龄、骨折类型、婚姻状况等方面相似，但活动≤24 h患者合并症较少，骨折前活动能力较好，社会地位较高。与动员24-36 h的患者（33.42%）相比，他们的LTOT风险（29.99%）也较低，加权风险差为3.44% （95% CI 1.58-5.30）。结论：髋部骨折术后LTOT较为常见。与术后24 - 36小时的活动相比，术后≤24小时的活动与较低的LTOT风险相关。早期活动是髋部骨折术后患者成功康复的关键因素之一，可以减少并发症和死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Geriatric Medicine GERIATRICS & GERONTOLOGY-

CiteScore

6.70

自引率

2.60%

发文量

114

审稿时长

6-12 weeks

期刊介绍： European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine. The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.