Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Surgeon. 2023 Dec;21(6):381-389. doi: 10.1016/j.surge.2023.07.007. Epub 2023 Aug 9.
We examined analgesic drug use before and after total hip arthroplasty (THA) by sex and age, and impact of comorbidity in that context.
Using Danish nationwide medical registries, we included 105,520 THA patients (1996-2018). We calculated prevalence of overall analgesic drug use and use of NSAIDs and opioids separately in four quarters before (-Q4 to -Q1) and after THA (Q1 to Q4). -Q4 and Q4 was compared using prevalence rate ratios (PRR) with 95% confidence interval (CI).
Among women, analgesic drug use was 46% in -Q4, 65% in Q1, but decreased to 31% in Q4 (PRR: 0.68 (CI: 0.67-0.69)). Among men, these numbers were 39% in -Q4, 62% in Q1, and 23% in Q4 (PRR: 0.61 (CI: 0.60-0.63)). Analgesic drug use was higher among older patients in all quarters except Q1. Analgesic drug use decreased from 40% in -Q4 to 25% in Q4 (PRR: 0.62 (CI: 0.59-0.64)) in patients <55 years, and from 44% to 30% in patients >85 years, (PRR: 0.67 (CI: 0.63-0.71)). Women used more NSAIDs and opioids than men. Older patients used more opioids compared to younger, while variation in NSAID use by age was small. Decrease in analgesic drug use from -Q4 to Q4 was least pronounced in patients with comorbidity history.
Women and older patients have higher prevalence of analgesic drug use before and after THA, and a smallest reduction in analgesic drug use from before to after THA. Comorbidity history modified these associations.
我们研究了全髋关节置换术（THA）前后按性别和年龄划分的镇痛药物使用情况，并探讨了合并症对此的影响。
我们使用丹麦全国性医疗登记处的数据，纳入了 105520 例 THA 患者（1996-2018 年）。我们计算了术前四个季度（-Q4 至 -Q1）和术后四个季度（Q1 至 Q4）中整体镇痛药物使用情况以及分别使用非甾体抗炎药（NSAIDs）和阿片类药物的情况。使用患病率比值（PRR）及其 95%置信区间（CI）比较-Q4 和 Q4。
在女性中，-Q4 时镇痛药物使用率为 46%，Q1 时为 65%，但在 Q4 时降至 31%（PRR：0.68（CI：0.67-0.69））。在男性中，这些数字分别为-Q4 时 39%，Q1 时 62%，Q4 时 23%（PRR：0.61（CI：0.60-0.63））。除 Q1 外，各年龄段患者在所有季度的镇痛药物使用率均较高。-Q4 时镇痛药物使用率为 40%，Q4 时降至 25%（PRR：0.62（CI：0.59-0.64）），55 岁以下患者降至 44%，85 岁以上患者降至 30%（PRR：0.67（CI：0.63-0.71））。女性比男性使用更多的 NSAIDs 和阿片类药物。与年轻患者相比，老年患者使用更多的阿片类药物，而年龄对 NSAID 使用的影响则较小。从-Q4 到 Q4，合并症病史患者的镇痛药物使用减少幅度最小。
女性和老年患者在 THA 前后的镇痛药物使用率较高，从术前到术后镇痛药物使用减少幅度最小。合并症病史改变了这些关联。
