The Association Between Potential Opioid-Related Adverse Drug Events and Outcomes in Total Knee Arthroplasty: A Retrospective Study

Jones, Mark R.; Kramer, MaryJo E; Beutler, Sascha S.; Kaye, Alan D.; Rao, Nikhilesh; Brovman, Ethan Y.; Urman, Richard D.

doi:10.1007/s12325-019-01122-1

Cited by 16 publications

(24 citation statements)

References 28 publications

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“…Halawi et al showed that opioid-based analgesia was significantly associated with increased LOS [ 8 ]. Another literature supported this result, showing that opioid use could lead to longer hospitalizations [ 11 ]. In addition, nausea and vomiting, which could increase complication risk and delay postoperative recovery, may be the side effects of opioid use [ 29 ].…”

Section: Discussionmentioning

confidence: 65%

Risk factors of opioid use associated with an enhanced-recovery programme after total knee arthroplasty

Cao

Xiang

Yang

et al. 2021

BMC Musculoskelet Disord

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Background Characterizing the impacts of postoperative opioid use on total knee arthroplasty (TKA) patients may help optimize the pain management after TKA. The aim of the study is to examine the prevalence and risk factors for opioid use with an enhanced-recovery programme after primary TKA. Methods We identified 361 patients undergoing TKA, and separated those on the basis of whether to receive opioid use after surgery. Themultivariate logistic regression model was used to identify independent risk factors for opioid use after primary TKA. Length of stay (LOS) and postoperative complications were also recorded and compared. Results The prevalence of opioid use after primary TKA was 23.0%. The significant risk factor was the longer operative time (OR [odds ratio] = 1.017, 95% CI [confidence interval] = 1.001 to 1.032, p = 0.034) and the protective factor was the utilization of tranexamic acid(OR= 0.355, 95% CI = 0.161 to 0.780, p = 0.010). In addition, the LOS was longer in opioid group (p < 0.05). Conclusion Considering the adverse health effects of opioid use, strategies need to be developed to prevent persistent opioid use after TKA. Reducing operative time and the application of tranexamic acid could lower the risk of opioid use with an enhanced-recovery programme after primary TKA.

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Section: Discussionmentioning

confidence: 65%

Risk factors of opioid use associated with an enhanced-recovery programme after total knee arthroplasty

Cao

Xiang

Yang

et al. 2021

BMC Musculoskelet Disord

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show abstract

“…These studies compared patients who experienced ORADEs and patients who did not (control group). Of these, 13 studies 11‐13,20‐29 involved a total of 1,887,711 surgical patients, one study 30 involved 731,208 medical patients, and two studies 31,32 involved a total of 355 hospitalized patients without stating the specialty (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Patient risk factors for opioid‐related adverse drug events in hospitalized patients: A systematic review

et al. 2022

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IntroductionOpioid utilization has increased fourfold over the past two decades among developed countries. Previous studies have found that opioid‐related adverse drug events (ORADEs) are strongly associated with adverse clinical outcomes in hospitalized patients. The Society of Hospital Medicine in the United States recently published a Consensus Statement regarding opioid safety and suggested that extra caution is needed when using opioids in patients with risk factors for ORADEs. This systematic review aimed to summarize common patient risk factors for ORADEs in hospitalized patients.MethodsFive databases were searched including Medline, Embase, Cochrane Central Register of Controlled Trials, International Pharmaceutical Abstracts, and Scopus. Search themes include opioids, adverse drug events, and acute care settings. Original full‐text studies that were published and identified patient risk factors for ORADEs in hospitalized patients were included.ResultsA total of 16 observational studies were included, with only two studies considered as poor quality. Seven studies focused on severe ORADEs including over‐sedation and respiratory depression. Common patient risk factors for severe ORADEs included comorbidities (eg, sleep apnea and renal diseases), concurrent use of sedatives, and prior opioid exposure. Nine studies focused on a combination of general ORADEs and common patient risk factors included advanced age, male gender, comorbidities (eg, chronic obstructive pulmonary disease and neurologic disorders), concurrent use of sedating medications, and prior opioid exposure. ConclusionsSuccessful identification of patient risk factors for ORADEs summarized by this systematic review could benefit clinicians when deciding on the appropriateness of opioid therapy in hospital patients. Future studies could focus on developing a validated risk assessment tool based on these risk factors.

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“…Halawi et al showed that opioid-based analgesia were signi cantly associated with increased LOS [7]. Another literature supported this result, showing that opioid use could lead to longer hospitalizations [10]. Moreover, nausea and vomiting, which could increase complication risk and delay postoperative recovery, may be the side effects of opioid use [27].…”

Section: Discussionmentioning

confidence: 97%

“…The risk factors for prolonged opioid use and opioid-related adverse drug events after TKA were extensively studied in previous studies [9][10][11][12]. However, the prevalence and related factors associated with whether or not use opioid after primary TKA was still poorly studied.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Opioid use Associated with an Enhanced-Recovery Programme after Total Knee Arthroplasty

Cao

Pei

2021

Preprint

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Background: The relationship between total knee arthroplasty (TKA) and postoperative opioid use is poorly studied. The aim of the study is to examine the prevalence and risk factors for opioid use with an enhanced-recovery programme after primary TKA.Methods: We identified 361 patients undergoing TKA, and separated those on the basis of whether to receive opioid use after surgery. Multivariate logistic regression model was used to identify independent risk factors for opioid use after primary TKA. Length of stay (LOS) and postoperative complications were recorded and compared.Results: The prevalence of opioid use after primary TKA was 23.0%. Significant risk factor were more operative time (OR [odds ratio] = 1.017, 95% CI [confidence interval] = 1.001 to 1.032, p = 0.034) and protective factor was tranexamic acid use (OR= 0.355, 95% CI = 0.161 to 0.780, p = 0.010). In addition, the LOS was longer in opioid group (p < 0.05).Conclusion: Considering the adverse health effects of opioid use, strategies need to be developed to prevent persistent opioid use. Reducing operative time and application of tranexamic acid could lower the risk of opioid use with an enhanced-recovery programme after primary TKA.

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The Association Between Potential Opioid-Related Adverse Drug Events and Outcomes in Total Knee Arthroplasty: A Retrospective Study

Cited by 16 publications

References 28 publications

Risk factors of opioid use associated with an enhanced-recovery programme after total knee arthroplasty

Risk factors of opioid use associated with an enhanced-recovery programme after total knee arthroplasty

Patient risk factors for opioid‐related adverse drug events in hospitalized patients: A systematic review

Risk Factors of Opioid use Associated with an Enhanced-Recovery Programme after Total Knee Arthroplasty

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