原发性髋关节镜手术后,阿片类药物相关疾病的诊断与较高的医疗资源利用率有关:一项国家数据库研究

Peter F. Monahan, Serkan Surucu, Natalie K. Pahapill, Andrew E. Jimenez, Kenneth F. Taylor
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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。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

Level of Evidence

Level III, Cohort Study

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