Evidence mapPaperPMID 40536348Full record

ArticleEuropean journal of pain (London, England)2025

Socioeconomic Position and Chronic Opioid Use After Hip Fracture Surgery: A Danish Population-Based Cohort Study.

Nickolaj Risbo, Vera Ehrenstein, Per Hviid Gundtoft, Jan-Erik Gjertsen, Alma Becic Pedersen

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Article in European journal of pain (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

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3citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

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3 · Its place in the literature

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3 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Nickolaj RisboDepartment of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Vera EhrensteinDepartment of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Per Hviid GundtoftDepartment of Orthopedic Surgery, Aarhus University Hospital, Aarhus, Denmark.
Jan-Erik GjertsenDepartment of Orthopedic Surgery, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Alma Becic PedersenDepartment of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.ORCID https://orcid.org/0000-0002-3288-9401

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic opioid use is a common and serious consequence of hip fracture. We examined the association between socioeconomic position (SEP) and chronic opioid use after hip fracture surgery.

methodsUsing nationwide Danish registries, we included patients aged ≥ 65 years undergoing hip fracture surgery in 2012-2021 (n = 52,801). Cohabitation, liquid assets, and education were markers of SEP. Chronic opioid use was defined as ≥ 2 prescriptions of opioids 31-365 days post-surgery. For the same period, all opioid doses were converted to morphine milligram equivalents (MME), mg/day. We used log-binomial regression to estimate adjusted risk ratios (aRR) with 95%-confidence intervals (CI) comparing patients within each SEP marker, adjusting for relevant confounding.

resultsThe 1-year risks of chronic opioid use were 33% for patients living alone versus 30% for patients cohabiting (aRR 1.05 [CI 1.02-1.09]), 37% for low versus 28% for high levels of liquid assets (aRR 1.28 [CI 1.23-1.34]), and 33% for low versus 28% for high education (aRR 1.19 [CI 1.14-1.25]). Patients living alone used 11.5 MME mg/day versus 9.8 mg/day in patients cohabiting, patients with low liquid assets used 14.8 versus 7.9 mg/day in patients with high liquid assets, and patients with low education used 11.8 versus 7.9 mg/day in patients with high education.

conclusionsAbout a third of hip fracture patients are using opioids continuously in the year after surgery. Living alone, less liquid assets, and low education were associated with a higher risk of opioid use and dosage of use, both in preoperative opioid users and non-users. SIGNIFICANCE STATEMENT: This study shows that among patients undergoing hip fracture surgery, low socioeconomic position measured by living alone, having less liquid assets or low education is associated with a higher risk of chronic opioid use and higher dosage of use in the first year postoperatively. Clinicians should consider socioeconomic position when prescribing opioids after hip fracture. The integration of less addictive opioids and non-pharmacological approaches in the pain management may reduce opioid use and improve patient safety.

Indexed as

Analgesics, OpioidHip FracturesOpioid-Related DisordersPostoperative PainSocial ClassAgedAged, 80 and overCohort StudiesDenmarkFemaleHumansMaleRegistriesSocioeconomic FactorsAnalgesics, Opioid

Identifiers

PMID40536348
PMCPMC12178151

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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.