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The Impact of Opioid-Related Disorder on Healthcare Resource Utilization Following Distal Radius Fracture Repair
Bergin M Brown1, Anthony M Castro2,3, Daisy V Lookinland1
1Drexel University College of Medicine, Philadelphia, PA.
Purpose:
This study assesses the impact of opioid-related disorders (ORDs) on healthcare utilization in patients following distal radius fractures (DRF) repair surgery-one of the most common fracture surgeries performed. The study hypothesis was that patients with ORD would experience higher rates of emergency department (ED) admissions, hospitalizations, and physical therapy (PT) evaluations compared to patients without ORD (NORD).
Methods:
The TriNetX US Collaborative Database was queried to identify patients who underwent DRF repair between the ages of 18 and 49 years. The ORD cohort was propensity matched in a 1:1 ratio to NORD patients based on age, sex, race, ethnicity, and other comorbidities to limit confounder influence of results. Postoperative rates of healthcare resource utilization outcomes, including hospital readmissions, ED visits, and PT utilization, were compared within 90 days of surgery and prescriptions were compared between 30 days and 1 year postoperatively.
Results:
A total of 789 patients were included in each cohort after propensity matching. Within 90 days postoperatively, a significantly greater percentage of ORD patients were admitted to the ED (21.8% vs 11.2% of NORD; P < .0001), hospitalized (13.6% vs 8.5% of NORD; P = .0013), and evaluated by PT (18.8% vs 12.0% of NORD; P = .0002). There was no significant difference in outpatient visits between groups (P = .9534). Within 30 days and 1 year postoperatively, patients in the ORD group received significantly more opioid prescriptions per patient (8.3 ± 17.4) compared to NORD patients (4.7 ± 8.8) (P = .002).
Conclusions:
ORD patients received significantly more opioid prescriptions and were more likely to be admitted to the ED, be hospitalized, or be evaluated by PT after DRF repair compared to those without ORD. Surgeons and healthcare teams should prepare for greater support of patients with ORD and consider deliberate strategies to minimize perioperative complications, while optimizing opioid stewardship.
Level Of Evidence:
Level 3 (retrospective cohort study).
