Evidence map›Paper›PMID 31637832›Full record

ArticleANZ journal of surgery2019

Opioid use prior to elective surgery is strongly associated with persistent use following surgery: an analysis of 14 354 Medicare patients.

Max Catchpool, Josh Knight, Jesse T Young, Philip Clarke, Michael J Barrington, Peter F M Choong, Michelle M Dowsey

Open access · hybridAbstract read
In one paragraph

Article in ANZ journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Max CatchpoolCentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0002-6382-9890
Josh KnightCentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Jesse T YoungJustice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Philip ClarkeCentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
Michael J BarringtonDepartment of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Melbourne, Victoria, Australia.
Peter F M ChoongDepartment of Surgery, The University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia.ORCID 0000-0002-3522-7374
Michelle M DowseyDepartment of Surgery, The University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia.ORCID 0000-0002-9708-5308
The University of Melbourne · AU

Funding

Centre of Excellence in Population Ageing Research, Australian Research Council (CEPAR) CE170100005NHMRC Career Development Fellowship APP1122526NHMRC Centre for Research Excellence in Total Joint Replacement OPtimising oUtcomes, equity, cost effectiveness and patient Selection (OPUS) APP1116325NHMRC Practitioner Fellowship APP1154203
6 · The paper itself

Abstract

backgroundPersistent opioid use following total joint replacement (TJR) surgery is common; however, the association between pre-surgical opioid use and surgery type has not been established. The objective of this study was to determine the association between pre-surgery opioid use and persistent post-surgery opioid use in TJR patients compared to other elective surgical patients.

methodsThis is a retrospective cohort study, of univariate and multinomial logistic regression of linked, de-identified Medicare Benefits Schedule and Pharmaceutical Benefits Schedule data, adjusted for perioperative opioid use, age and sex. Oral morphine equivalents daily doses (OMEDD) were calculated and opioid use was categorized into three mutually exclusive categories for each observation window: low (0-5 OMEDD), moderate (5-10 OMEDD), high (10+ OMEDD). Persistent opioid use was defined as opioid use between 180 and 270 days after the date of surgery.

resultsPersistent opioid use was associated with older age, female gender and pre-surgery opioid use. There was no increased risk for persistent opioid use for TJR patients compared to other surgical patients. The intensity of pre-surgery opioid usage is strongly associated with persistent opioid use in all observed surgical patients.

conclusionsOur results suggest that many patients who use opioids prior to surgery will persist in their opioid use following surgery. No association was found between persistent opioid use and TJR surgery, but rather a risk reduction compared to other elective surgeries when associations with opioid use are controlled for. Primary care clinicians and surgeons should monitor the duration and dosage of perioperative opioid use.

Indexed as

Administration, OralAdultAgedAnalgesics, OpioidArthroplasty, ReplacementCase-Control StudiesElective Surgical ProceduresFemaleHumansMaleMedicareMiddle AgedMorphineOpioid-Related DisordersPerioperative CarePostoperative PainAnalgesics, OpioidMorphinegeneral surgeryorthopaedic surgeryurology

Identifiers

PMID31637832
PMCPMC6900005
OpenAlexW2981432042

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.