Opioid Use Disorders Are Associated with Perioperative Morbidity and Mortality in the Hip Fracture Population

Spencer Summers, Luis Grau, Dustin Massel, Samuel Rosas, Alvin Ong, Victor Hernandez

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives: To determine whether opioid use disorders (OUDs) are associated with adverse perioperative outcomes in patients undergoing surgical fixation for proximal femur fractures. Methods: The National Hospital Discharge Survey was queried to identify patients surgically treated for proximal femur fractures between 1990 and 2007. Patients were grouped into those with a diagnosis of OUD, nonopioid drug use disorder, or neither. Demographic information and comorbidities were included in univariable and multivariable analyses to identify independent risk factors for perioperative outcomes. Results: A total of 8154 patients with a diagnosis of drug use disorder and 4704 patients with a diagnosis of OUD were identified from a cohort of 4,732,165 surgically treated proximal femur fractures. Patients with OUD were significantly younger (46 vs. 79), and a significantly smaller proportion of them had medical comorbidities (21.9% vs. 60.2%) when compared with the no drug misuse cohort. Patients with OUD had significantly more medical complications (51.1% vs. 26.8%), mechanical complications (3% vs. 0.3%), and adverse events (55% vs. 39.7%) when compared with the no drug misuse group. OUD had higher odds for leaving against medical advice [odds ratio (OR) 12.868, range 10.7771-15.375], for any adverse event (OR 4.107, range 3.869-4.360), and for mortality (OR 1.744, range 1.250-2.433) when compared with nondrug misusers. Conclusions: Despite being younger and with significantly less medical comorbidities, patients with OUD have higher odds for adverse events, leaving against medical advice, and mortality after surgical treatment of a hip fracture.

Original languageEnglish (US)
Pages (from-to)238-244
Number of pages7
JournalJournal of Orthopaedic Trauma
Volume32
Issue number5
DOIs
StatePublished - May 1 2018

Fingerprint

Hip Fractures
Opioid Analgesics
Morbidity
Mortality
Population
Femur
Comorbidity
Odds Ratio
Substance-Related Disorders
Health Care Surveys
Pharmaceutical Preparations
Demography

Keywords

  • hip fracture
  • independent risk
  • mortality
  • opioid abuse
  • perioperative outcomes

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Opioid Use Disorders Are Associated with Perioperative Morbidity and Mortality in the Hip Fracture Population. / Summers, Spencer; Grau, Luis; Massel, Dustin; Rosas, Samuel; Ong, Alvin; Hernandez, Victor.

In: Journal of Orthopaedic Trauma, Vol. 32, No. 5, 01.05.2018, p. 238-244.

Research output: Contribution to journalArticle

Summers, Spencer ; Grau, Luis ; Massel, Dustin ; Rosas, Samuel ; Ong, Alvin ; Hernandez, Victor. / Opioid Use Disorders Are Associated with Perioperative Morbidity and Mortality in the Hip Fracture Population. In: Journal of Orthopaedic Trauma. 2018 ; Vol. 32, No. 5. pp. 238-244.
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