Swiggett Samuel J, Ciminero Matthew L, Weisberg Miriam D, Vakharia Rushabh M, Sadeghpour Ramin, Choueka Jack
Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.
Shoulder Elbow. 2022 Aug;14(4):395-401. doi: 10.1177/1758573221994790. Epub 2021 Mar 2.
The purpose of this study was to investigate whether patients undergoing primary shoulder arthroplasty with opioid use disorder have higher rates of (1) implant-related complications; (2) in-hospital lengths of stay; (3) readmission rates; and (4) costs of care.
Opioid use disorder patients undergoing primary shoulder arthroplasty were queried and matched in a 1:5 ratio to controls by age, sex, and medical comorbidities within the Medicare database. The query yielded 25,489 patients with ( = 4253) and without ( = 21,236) opioid use disorder. Primary outcomes analyzed included: 2-year implant related complications, in-hospital lengths of stay, 90-day readmission rates, and 90-day costs of care. A value less than 0.01 was considered statistically significant.
Opioid use disorder patients had significantly longer in-hospital lengths of stay (3 days vs. 2 days; 0.0001) compared to matched controls. Opioid use disorder patients were also found to have higher incidence and odds (OR) of readmission rates (12.84 vs. 7.45%; OR: 1.16, 0.0001) and implant-related complications (20.03 vs. 7.95%; OR: 1.82, 0.0001). Study group patients also incurred significantly higher 90-day costs of care ($16,918.85 vs. $15,195.37, 0.0001).
This study can be used to help further augment efforts to reduce opioid prescriptions from healthcare providers in shoulder arthroplasty settings.
本研究的目的是调查患有阿片类药物使用障碍的初次肩关节置换术患者是否有更高的（1）植入物相关并发症发生率；（2）住院时间；（3）再入院率；以及（4）护理费用。
在医疗保险数据库中，对患有阿片类药物使用障碍的初次肩关节置换术患者进行查询，并按年龄、性别和合并症以1:5的比例与对照组进行匹配。该查询产生了25489名患者，其中有（n = 4253）和没有（n = 21236）阿片类药物使用障碍。分析的主要结果包括：2年植入物相关并发症、住院时间、90天再入院率和90天护理费用。p值小于0.01被认为具有统计学意义。
与匹配的对照组相比，患有阿片类药物使用障碍的患者住院时间明显更长（3天对2天；p = 0.0001）。还发现患有阿片类药物使用障碍的患者再入院率的发生率和比值比（OR）更高（12.84%对7.45%；OR：1.16，p = 0.0001）以及植入物相关并发症（20.03%对7.95%；OR：1.82，p = 0.0001）。研究组患者的90天护理费用也明显更高（16918.85美元对15195.37美元，p = 0.0001）。
本研究可用于帮助进一步加大力度，减少医疗保健提供者在肩关节置换术中开具阿片类药物的处方。
