Researchers examined 6,043 preoperative opioid users who underwent a total knee, hip or shoulder replacement in 2014-15. The preoperative opioid users had a median morphine equivalent daily dose of 32 milligrams.
What they found:
1. Preoperative opioid use increased:
- Length of stay
- Non-home discharge
- 30-day unplanned readmissions
2. Preoperative opioid users experienced 35 percent higher surgical site infection rates than a control group and had a 44 percent higher surgical revision rate.
3. Medical spend also increased by a median of $1,084 during the year following discharge.
4. Users had a 64 percent lower rate of opioid cessation than patients who did not fill two or more prescriptions across periods.
Researchers concluded: “Preoperative opioid users had longer length of stay, increased revision rates, higher spend, and persistent opioid use, which worsened with dose. Adverse outcomes after elective joint replacement may be reduced if preoperative opioid risk is managed through increased monitoring or opioid cessation.”
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