Admission NarxCare Narcotic Scores Are Associated With Increased Odds of Readmission and Prolonged Length of Hospital Stay After Primary Elective Total Knee Arthroplasty.
Admission NarxCare Narcotic Scores Are Associated With Increased Odds of Readmission and Prolonged Length of Hospital Stay After Primary Elective Total Knee Arthroplasty.
复制标题
入院麻醉性麻醉分数与初次选修全膝关节置换术后的再入院几率和住院时间延长有关。
DOI：
10.5435/jaaosglobal-d-22-00040
复制
发表时间：
2022-12-01
影响因子：
1.5
通讯作者：
Rubin, Lee E
中科院分区：
文献类型：
--
作者：
Galivanche, Anoop R;Zhu, Justin;Mercier, Michael R;McLean, Ryan;Wilhelm, Christopher V;Varthi, Arya G;Grauer, Jonathan N;Rubin, Lee E
术前麻醉剂使用与初次选择性全膝关节置换术（TKA）术后结局的相关性仍不明确。NarxCare平台分析患者的州处方药监测计划记录，以分配近似患者总体阿片类药物使用的数值分数。本研究调查了入院NarxCare麻醉评分在预测初次择期TKA后不良事件（AE）发生率方面的效用。对2017年10月至2020年5月期间在一家机构进行的择期初次TKA患者进行了评价。对入院时的NarxCare麻醉评分、患者特征、30天AE、再入院、翻修手术和死亡率进行了提取。根据入院时的NarxCare麻醉评分对择期TKA患者进行分组。比较了发生不良结局的几率。共有1136例患者符合研究入选标准（Narx评分0：n = 293 [25.8%]，1 - 99：n = 253 [22.3%]，100 - 299：n = 368 [32.4%]，300 - 499：n = 161 [14.2%]，500+：n = 61 [5.37%]）。通过logistic回归分析，入院麻醉评分较高的患者住院时间延长、30天内再入院和聚集AE的几率倾向于呈剂量依赖性增加。入院麻醉评分可用于预测再入院并按不良事件风险对全膝关节置换术患者进行分层。
The association of preoperative narcotic use with postoperative outcomes after primary elective total knee arthroplasty (TKA) has remained poorly characterized. The NarxCare platform analyzes patients' state Prescription Drug Monitoring Program records to assign numerical scores that approximate a patient's overall opioid usage. The present study investigated the utility of admission NarxCare narcotic scores in predicting the odds of adverse events (AEs) after primary elective TKA. Elective primary TKA patients performed at a single institution between October 2017 and May 2020 were evaluated. NarxCare narcotic scores at the time of admission, patient characteristics, 30-day AEs, readmissions, revision surgeries, and mortality were abstracted. Elective TKA patients were binned based on admission NarxCare narcotic scores. The odds of experiencing adverse outcomes were compared. In total, 1136 patients met the criteria for inclusion in the study (Narx Score 0: n = 293 [25.8%], 1 to 99: n = 253 [22.3%], 100 to 299: n = 368 [32.4%], 300 to 499: n = 161 [14.2%], and 500+: n = 61 [5.37%]). By logistic regression, patients with higher admission narcotic scores tended to have a dose-dependent increase in the odds of prolonged length of hospital stay, readmission within 30 days, and aggregated AEs. Admission narcotic scores may be used to predict readmission and to stratify TKA patients by risk of AEs.