Development of a Medicare Claims-Based Model to Predict Persistent High-Dose Opioid Use After Total Knee Replacement.
Development of a Medicare Claims-Based Model to Predict Persistent High-Dose Opioid Use After Total Knee Replacement.
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DOI：
10.1002/acr.24559
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发表时间：
2022-08
影响因子：
4.7
通讯作者：
Kim SC
中科院分区：
文献类型：
--
作者：
Gopalakrishnan C;Desai RJ;Franklin JM;Jin Y;Lii J;Solomon DH;Katz JN;Lee YC;Franklin PD;Kim SC
To develop a claims-based model to predict persistent high-dose opioid use amongst patients undergoing total knee replacement (TKR). Using Medicare claims (2010–2014), we identified patients ≥65 years who underwent TKR with no history of high-dose opioid use (>25 mean morphine equivalents (MME)/day) in the year prior. We used group-based trajectory modeling to identify distinct opioid use patterns. The primary outcome was persistent high-dose opioid use in the year after TKR. We split the data into training (2010–2013) and test (2014) sets and used logistic regression with least absolute shrinkage and selection operator (LASSO) regularization utilizing a total of 83 pre-operative patient characteristics as candidate predictors. A reduced model with ten pre-specified variables which included demographics, opioid use and medication history was also considered. The final study cohort included 142,089 patients who underwent TKR. The group-based trajectory model identified 4 distinct trajectories of opioid use (Group 1- short-term, low-dose, Group 2- moderate-duration, low-dose, Group 3- moderate-duration, high-dose, and Group 4-persistent high-dose). The model predicting persistent high-dose opioid use achieved high discrimination (area under the receiver operating characteristic curve (AUC) of 0.85; 95% CI, 0.84–0.86)) in the test set. The reduced model with ten predictors performed equally well (AUC=0.84; 95% CI, 0.84–0.85). In this cohort of older patients, 10.6% became persistent high dose (mean=22.4 MME/day) opioid users after TKR. Our model with 10 readily available clinical factors may help identify patients at high risk of future adverse outcomes from persistent opioid use after TKR.
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DOI：
10.1016/j.jpain.2008.10.008
发表时间：
2009-02
期刊：
The journal of pain
影响因子：
--
作者：
Chou R;Fanciullo GJ;Fine PG;Adler JA;Ballantyne JC;Davies P;Donovan MI;Fishbain DA;Foley KM;Fudin J;Gilson AM;Kelter A;Mauskop A;O'Connor PG;Passik SD;Pasternak GW;Portenoy RK;Rich BA;Roberts RG;Todd KH;Miaskowski C;American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
通讯作者：
American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
影响因子：
6
作者：
Burke, Laura G.;Zhou, Xiner;Frakt, Austin B.
通讯作者：
Frakt, Austin B.
影响因子：
4.8
作者：
Franklin, Jessica M.;Gopalakrishnan, Chandrasekar;Choudhry, Niteesh K.
通讯作者：
Choudhry, Niteesh K.
影响因子：
33.9
作者：
Lippold, Kumiko M.;Jones, Christopher M.;Giroir, Brett P.
通讯作者：
Giroir, Brett P.
影响因子：
3.5
作者：
Karhade, Aditya, V;Schwab, Joseph H.;Bedair, Hany S.
通讯作者：
Bedair, Hany S.