Peter F. Monahan, Serkan Surucu, Natalie K. Pahapill, Andrew E. Jimenez, Kenneth F. Taylor
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Postoperative rates of adverse events and medical resources were compared within 90 days of procedure, prescriptions were compared within 1 year, and revision surgery were compared within 2 years.</p><h3>Results</h3><p>A total of 809 ORD patients were propensity matched in a 1:1 ratio to NORD patients. Postoperative adverse events were similar between groups (P = .693). Rates of revision arthroscopy were also similar for both ORD (9.3%) and NORD (8.0%) cohorts (OR: 1.17 [95% CI 0.83-1.66]; P = .377). ORD patients received care from the emergency department, inpatient admission, outpatient visit, and physical therapy evaluations at higher rates. The ORD cohort received a greater amount of new opioid (OR: 2.66 [95% CI 2.17-3.26]; P < .0001) and antidepressant prescriptions (OR: 1.58 [95%CI 1.26 -1.97]; P < .0001) compared to NORD patients within 1 year of surgery.</p><h3>Conclusion</h3><p>ORD patients demonstrated similar rates of adverse events and revision surgery when compared to a propensity matched group of NORD patients undergoing primary hip arthroscopy. However, ORD patients experienced increased rates of ED visits, hospitalizations and were prescribed higher rates of opioid and antidepressant prescriptions.</p><h3>Level of Evidence</h3><p>Level III, Cohort Study</p>","PeriodicalId":501029,"journal":{"name":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prior Diagnosis of Opioid Related Disorder is Associated with Higher Medical Resource Utilization Following Primary Hip Arthroscopy: A National Database Study\",\"authors\":\"Peter F. Monahan, Serkan Surucu, Natalie K. Pahapill, Andrew E. Jimenez, Kenneth F. Taylor\",\"doi\":\"10.1016/j.arthro.2023.12.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3>Purpose</h3><p>To compare adverse events, medical resource utilization, prescribing patterns and revision surgery rates of patients with opioid related disorders (ORD) undergoing primary hip arthroscopy against a propensity matched group with no opioid related disorders (NORD).</p><h3>Methods</h3><p>The TriNetX database was queried between January 2015 and December 2020 using ICD-10 and CPT codes to identify patients undergoing primary hip arthroscopy between ages 18 and 70. The ORD cohort was propensity matched in a 1:1 ratio to NORD patients based on age, sex, alcohol related disorders, heart disease, hypertension, metabolic disorders, anxiety disorders, major depressive disorder, diabetes mellitus, and anti-depressant prescriptions. Postoperative rates of adverse events and medical resources were compared within 90 days of procedure, prescriptions were compared within 1 year, and revision surgery were compared within 2 years.</p><h3>Results</h3><p>A total of 809 ORD patients were propensity matched in a 1:1 ratio to NORD patients. Postoperative adverse events were similar between groups (P = .693). Rates of revision arthroscopy were also similar for both ORD (9.3%) and NORD (8.0%) cohorts (OR: 1.17 [95% CI 0.83-1.66]; P = .377). ORD patients received care from the emergency department, inpatient admission, outpatient visit, and physical therapy evaluations at higher rates. The ORD cohort received a greater amount of new opioid (OR: 2.66 [95% CI 2.17-3.26]; P < .0001) and antidepressant prescriptions (OR: 1.58 [95%CI 1.26 -1.97]; P < .0001) compared to NORD patients within 1 year of surgery.</p><h3>Conclusion</h3><p>ORD patients demonstrated similar rates of adverse events and revision surgery when compared to a propensity matched group of NORD patients undergoing primary hip arthroscopy. 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引用次数: 0
摘要
目的比较接受初级髋关节镜检查的阿片相关疾病（ORD）患者与无阿片相关疾病（NORD）倾向匹配组的不良事件、医疗资源利用率、处方模式和翻修手术率。方法在 2015 年 1 月至 2020 年 12 月期间，使用 ICD-10 和 CPT 编码查询 TriNetX 数据库，以识别年龄在 18 岁至 70 岁之间接受初级髋关节镜检查的患者。根据年龄、性别、酒精相关疾病、心脏病、高血压、代谢性疾病、焦虑症、重度抑郁症、糖尿病和抗抑郁药处方，按 1:1 的比例将 ORD 队列与 NORD 患者进行倾向匹配。比较了术后90天内的不良事件发生率和医疗资源，比较了1年内的处方，并比较了2年内的翻修手术。两组患者术后不良反应相似（P = .693）。ORD 组（9.3%）和 NORD 组（8.0%）的关节镜翻修率也相似（OR：1.17 [95% CI 0.83-1.66]；P = .377）。ORD患者接受急诊科治疗、住院治疗、门诊治疗和理疗评估的比例较高。与接受初级髋关节镜手术的 NORD 患者相比，ORD 患者在术后 1 年内接受了更多的新阿片类药物处方（OR：2.66 [95%CI 2.17-3.26]；P <；.0001）和抗抑郁药物处方（OR：1.58 [95%CI 1.26-1.97]；P <；.0001）。然而，ORD 患者的急诊室就诊率和住院率均有所上升，阿片类药物和抗抑郁药物的处方率也更高。
Prior Diagnosis of Opioid Related Disorder is Associated with Higher Medical Resource Utilization Following Primary Hip Arthroscopy: A National Database Study
Purpose
To compare adverse events, medical resource utilization, prescribing patterns and revision surgery rates of patients with opioid related disorders (ORD) undergoing primary hip arthroscopy against a propensity matched group with no opioid related disorders (NORD).
Methods
The TriNetX database was queried between January 2015 and December 2020 using ICD-10 and CPT codes to identify patients undergoing primary hip arthroscopy between ages 18 and 70. The ORD cohort was propensity matched in a 1:1 ratio to NORD patients based on age, sex, alcohol related disorders, heart disease, hypertension, metabolic disorders, anxiety disorders, major depressive disorder, diabetes mellitus, and anti-depressant prescriptions. Postoperative rates of adverse events and medical resources were compared within 90 days of procedure, prescriptions were compared within 1 year, and revision surgery were compared within 2 years.
Results
A total of 809 ORD patients were propensity matched in a 1:1 ratio to NORD patients. Postoperative adverse events were similar between groups (P = .693). Rates of revision arthroscopy were also similar for both ORD (9.3%) and NORD (8.0%) cohorts (OR: 1.17 [95% CI 0.83-1.66]; P = .377). ORD patients received care from the emergency department, inpatient admission, outpatient visit, and physical therapy evaluations at higher rates. The ORD cohort received a greater amount of new opioid (OR: 2.66 [95% CI 2.17-3.26]; P < .0001) and antidepressant prescriptions (OR: 1.58 [95%CI 1.26 -1.97]; P < .0001) compared to NORD patients within 1 year of surgery.
Conclusion
ORD patients demonstrated similar rates of adverse events and revision surgery when compared to a propensity matched group of NORD patients undergoing primary hip arthroscopy. However, ORD patients experienced increased rates of ED visits, hospitalizations and were prescribed higher rates of opioid and antidepressant prescriptions.
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