Department of Orthopedic Surgery, University of Miami Hospital, Miami, Florida.
Holy Cross Hospital, Orthopedic Research Institute, Ft Lauderdale, Florida.
Foot Ankle Spec. 2021 Jun;14(3):232-237. doi: 10.1177/1938640020914715. Epub 2020 Apr 9.
Ankle fractures are common and may require open reduction and internal fixation (ORIF). Literature is scarce evaluating the associations of opioid use disorder (OUD) with ORIF postoperative outcomes. This study investigates whether OUD patients have increased (1) costs of care, (2) emergency room visits, and (3) readmission rates.
ORIF patients with a 90-day history of OUD were identified using an administrative claims database. OUD patients were matched (1:4) to controls by age, sex, and medical comorbidities. The Welch t-test determined the significance of cost of care. Logistic regression yielded odds ratios (ORs) for emergency room visits and 90-day readmission rates.
A total of 2183 patients underwent ORIF (n = 485 with OUD vs n = 1698 without OUD). OUD patients incurred significantly higher costs of care compared with controls ($5921.59 vs $5128.22, P < .0001). OUD patients had a higher incidence and odds of emergency room visits compared with controls (3.50% vs 0.64%; OR = 5.57, 95% CI = 2.59-11.97, P < .0001). The 90-day readmission rates were not significantly different between patients with and without OUD (8.65% vs 7.30%; OR = 1.20, 95% CI = 0.83-1.73, P = .320).
OUD patients have greater costs of care and odds of emergency room visits within 90 days following ORIF. Level III: Retrospective cohort study.
踝关节骨折较为常见，可能需要切开复位内固定（ORIF）。文献中评估阿片类药物使用障碍（OUD）与 ORIF 术后结果之间关联的内容很少。本研究调查 OUD 患者是否存在以下情况：（1）增加医疗费用；（2）增加急诊就诊次数；（3）增加再入院率。
通过医疗补助索赔数据库，确定 90 天内有 OUD 病史的 ORIF 患者。OUD 患者按年龄、性别和合并症与对照组（1:4）匹配。采用 Welch t 检验确定医疗费用的显著性。使用逻辑回归得出急诊就诊和 90 天再入院率的比值比（OR）。
共有 2183 名患者接受 ORIF（n = 485 例有 OUD，n = 1698 例无 OUD）。与对照组相比，OUD 患者的医疗费用显著更高（5921.59 美元 vs 5128.22 美元，P <.0001）。与对照组相比，OUD 患者急诊就诊的发生率和几率更高（3.50% vs 0.64%；OR = 5.57，95%CI = 2.59-11.97，P <.0001）。有 OUD 和无 OUD 的患者 90 天内的再入院率无显著差异（8.65% vs 7.30%；OR = 1.20，95%CI = 0.83-1.73，P =.320）。
与 ORIF 后 90 天内的对照组相比，OUD 患者的医疗费用更高，急诊就诊的几率更大。III 级：回顾性队列研究。
