AAOS: Some Seniors May Continue Opioid Use After Hip Fracture Surgery

One out of every six older hip fracture patients is still taking opioid pain medications three to six months after surgery, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from Aug. 31 to Sept. 3 in San Diego.

Kanu M. Okike, M.D., from the Kaiser Permanente Moanalua Medical Center in Honolulu, and colleagues assessed the prevalence of and risk factors for prolonged opioid usage following hip fracture in opioid-naive older individuals. The analysis included 29,618 opioid-naive patients (aged ≥60 years) who underwent surgical treatment of a hip fracture at one of 35 hospitals owned by a large U.S. health maintenance organization between 2009 and 2018.

The researchers found that the proportion of outpatient opioid usage was 83.7 percent from day 0 to day 30 after surgery, 69.0 percent from day 31 to day 90, and 16.7 percent from day 91 to day 180. Risk factors for persistent opioid usage in an adjusted analysis included younger age (60 to 69 years), female sex, body mass index ≥30 kg/m², current/former smoking, American Society of Anesthesiologists classification ≥3, and a history of substance abuse. In contrast, persistent opioid usage was less commonly seen among patients who were Asian, had an annual income of ≥$150,000, or had undergone regional anesthesia. Persistent opioid usage was more likely following fracture fixation surgery and less likely following total hip arthroplasty (using hemiarthroplasty as the reference group).

“While prior research on the hazards of opioids in the elderly has primarily focused on short-term risks such as oversedation and delirium, these results suggest that addiction and chronic opioid use may represent risks for this older population as well,” the authors write.

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