Risk Factors for Prolonged Opioid Use After Open Treatment of Distal Radius Fractures.

Area of Science:

• Orthopedic Surgery
• Pain Management
• Health Services Research

Background:

• Open treatment of distal radius fractures is a common orthopedic procedure.
• Postoperative opioid use is a significant concern following orthopedic surgery.
• Identifying factors associated with opioid use is crucial for effective pain management strategies.

Purpose of the Study:

• To evaluate factors associated with postoperative opioid use after open treatment of distal radius fractures.
• To differentiate between limited and persistent opioid use in the postoperative period.
• To identify modifiable and non-modifiable risk factors for persistent opioid use.

Main Methods:

• Retrospective analysis of the Humana insurance claims database.
• Inclusion of patients who underwent open treatment for distal radius fractures.
• Defined limited opioid use (one prescription) and persistent opioid use (multiple prescriptions) within 6 months post-surgery.
• Logistic regression models to identify associated risk factors, with subgroup analyses for opioid-naïve and open fracture patients.

Main Results:

• Identified 9141 patients with limited and persistent opioid use.
• Significant risk factors for persistent opioid use included nonhome discharge, inpatient setting, long-term pain, tobacco abuse, and age < 65 years.
• Preoperative opioid use within 1 month (OR 2.6) and 1-6 months (OR 4.0) before surgery strongly predicted persistent postoperative opioid use.

Conclusions:

• Numerous risk factors are associated with postoperative opioid use after open distal radius fracture treatment.
• Understanding these risk factors is essential for developing targeted interventions to reduce opioid consumption.
• Preoperative opioid use is a critical predictor of persistent postoperative opioid use, suggesting the need for careful preoperative assessment and management.