Prolonged opioid use in trauma patients: A multicenter cohort study

Area of Science:

• Trauma surgery
• Pain management
• Public health

Background:

• Trauma patients face high risks of long-term prescription opioid use (LTPOU) due to prevalent postinjury pain.
• Risk factors for LTPOU in trauma populations are not well understood.
• Understanding LTPOU predictors and outcomes is crucial for this vulnerable group.

Purpose of the Study:

• To identify predictors of LTPOU in trauma patients.
• To examine the long-term functional outcomes associated with LTPOU in trauma survivors.

Main Methods:

• Retrospective cohort study of 809 trauma patients (Injury Severity Score ≥9).
• Patients surveyed 6-12 months post-injury regarding LTPOU (defined as opioid use within 3 months of survey).
• Stepwise logistic regression used to identify LTPOU predictors, adjusting for covariates.

Main Results:

• 15.7% of patients reported LTPOU.
• Predictors of LTPOU included comorbid conditions, work-related injuries, Medicaid insurance, low education, prior mental health disorders, and polytrauma.
• LTPOU was associated with PTSD, financial hardship, and functional limitations, regardless of chronic pain status.

Conclusions:

• Nearly 16% of trauma patients reported LTPOU.
• Key predictors identified were prior mental health issues, low education, Medicaid insurance, comorbidities, and polytraumatic/work-related injuries.
• LTPOU is linked to adverse functional outcomes, highlighting the need for targeted interventions.