University of Maryland School of Medicine, Baltimore, USA.
University of Maryland School of Medicine and University of Maryland Rehabilitation & Orthopaedic Institute, Baltimore, USA.
Hand (N Y). 2022 Sep;17(5):905-912. doi: 10.1177/1558944720974122. Epub 2021 Jan 19.
The objectives of this study were to determine the baseline patient characteristics associated with preoperative opioid use and to establish whether preoperative opioid use is associated with baseline patient-reported outcome measures in patients undergoing common hand surgeries.
Patients undergoing common hand surgeries from 2015 to 2018 were retrospectively reviewed from a prospective orthopedic registry at a single academic institution. Medical records were reviewed to determine whether patients were opioid users versus nonusers. On enrollment in the registry, patients completed 6 Patient-Reported Outcomes Measurement Information System (PROMIS) domains (Physical Function, Pain Interference, Fatigue, Social Satisfaction, Anxiety, and Depression), the Brief Michigan Hand Questionnaire (BMHQ), a surgical expectations questionnaire, and Numeric Pain Scale (NPS). Statistical analysis included multivariable regression to determine whether preoperative opioid use was associated with patient characteristics and preoperative scores on patient-reported outcome measures.
After controlling for covariates, an analysis of 353 patients (opioid users, n = 122; nonusers, n = 231) showed that preoperative opioid use was associated with higher American Society of Anesthesiologists class (odds ratio [OR], 2.88), current smoking (OR, 1.91), and lower body mass index (OR, 0.95). Preoperative opioid use was also associated with significantly worse baseline PROMIS scores across 6 domains, lower BMHQ scores, and NPS hand scores.
Preoperative opioid use is common in hand surgery patients with a rate of 35%. Preoperative opioid use is associated with multiple baseline patient characteristics and is predictive of worse baseline scores on patient-reported outcome measures. Future studies should determine whether such associations persist in the postoperative setting between opioid users and nonusers.
本研究旨在确定与术前使用阿片类药物相关的基线患者特征，并确定术前使用阿片类药物是否与接受常见手部手术的患者的基线患者报告的结果测量值相关。
从一家学术机构的前瞻性骨科注册处回顾性地审查了 2015 年至 2018 年接受常见手部手术的患者。查阅病历以确定患者是否为阿片类药物使用者或非使用者。在注册时，患者完成了 6 个患者报告的结果测量信息系统（PROMIS）域（身体机能、疼痛干扰、疲劳、社会满意度、焦虑和抑郁）、简短密歇根手问卷（BMHQ）、手术期望问卷和数字疼痛量表（NPS）。统计分析包括多变量回归，以确定术前使用阿片类药物是否与患者特征和患者报告的结果测量值的术前评分相关。
在控制协变量后，对 353 名患者（阿片类药物使用者，n = 122；非使用者，n = 231）的分析表明，术前使用阿片类药物与更高的美国麻醉医师协会（ASA）分级（优势比[OR]，2.88）、当前吸烟（OR，1.91）和较低的体重指数（OR，0.95）相关。术前使用阿片类药物也与 6 个领域的 PROMIS 基线评分明显更差、BMHQ 评分和 NPS 手部评分较低相关。
术前使用阿片类药物在手部手术患者中很常见，发生率为 35%。术前使用阿片类药物与多种基线患者特征相关，并预测患者报告的结果测量值的基线评分更差。未来的研究应确定在术后环境中，阿片类药物使用者和非使用者之间是否存在这种关联。
