Impact of Pre-operative Opioid Use on Racial Disparities in Adverse Outcomes Post Total Knee and Hip Arthroplasty.
Impact of Pre-operative Opioid Use on Racial Disparities in Adverse Outcomes Post Total Knee and Hip Arthroplasty.
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术前使用阿片类药物对全膝关节和髋关节置换术后不良后果的种族差异的影响。
DOI：
10.1007/s40615-022-01479-0
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发表时间：
2023
影响因子：
3.9
通讯作者：
Ma,Yan
中科院分区：
文献类型：
--
作者：
Mohammed,Hina;Parks,Michael;Ibrahim,Said;Magnus,Manya;Ma,Yan
在美国，日益增长的阿片类药物流行病具有潜在的种族差异维度。此外，研究表明，少数民族患者在重大骨科手术后发生不良事件的风险更高。我们研究的目的是确定术前阿片类药物使用障碍（OUDs）是否影响TKA和THA术后患者出现不良术后结果的可能性的种族差异。方法收集2005-2014年全国住院患者样本数据库中TKA和THA患者的数据。我们使用回归模型来评估相对于种族群体，oud对不良结局几率的影响。不良结果包括任何住院术后并发症、住院时间延长（LOS）和非家庭出院。结果在我们以白人患者为参照组的完全调整回归模型中，我们发现在延长的LOS和非家庭出院方面，oud与种族差异相关。在非OUD组中，黑人患者延长LOS的几率明显较高（OR: 1.35, 95% CI: 1.26-1.46，p值：< 0.0001），而有OUD病史的患者延长LOS的几率不显著较低（OR: 0.94, 95% CI: 0.69-1.29，p值：0.71）。同样，对于非家庭出院的结果，非OUD组的黑人患者的赔率显着较高（OR: 1.31, 95% CI: 1.21-1.43，p值：< 0.0001），而有OUD病史的患者的赔率显着较低（OR: 0.91, 95% CI: 0.64-1.29，p值：0.59）。结论：非OUD组患者的不良事件存在显著的种族差异，但在OUD组中这些差异减弱。
IntroductionThe growing opioid epidemic in the USA has underlying racial disparities dimensions. Also, studies have shown that patients from minority racial groups are at higher risk of adverse events following major orthopedic surgery. The aim of our study was to determine whether pre-operative opioid-use disorders (OUDs) impacted racial disparities in the likelihood of patients experiencing adverse post-operative outcomes following TKA and THA.MethodsData about patients undergoing TKA and THA were collected from the 2005–2014 National Inpatient Sample databases. Regression modeling was used to assess the impact of OUDs on odds of adverse outcomes comparing racial groups. The adverse outcomes included any in-hospital post-surgical complications, prolonged length of stay (LOS), and nonhome discharge.ResultsIn our fully adjusted regression models using White patients as the reference group, we found that OUDs were associated with racial disparities in prolonged LOS and nonhome discharge. In the non-OUD group, Black patients had significantly higher odds of longer LOS (OR: 1.35, 95% CI: 1.26–1.46,p-value: < 0.0001), whereas those with history of OUD had non-significantly lower odds of longer LOS (OR: 0.94, 95% CI: 0.69–1.29,p-value: 0.71). Similarly, for the outcome of nonhome discharges, Black patients in the non-OUD group had significantly higher odds (OR: 1.31, 95% CI: 1.21–1.43,p-value: < 0.0001) and those with a history of OUD had non-significantly lower odds (OR: 0.91, 95% CI: 0.64–1.29,p-value: 0.59).ConclusionsSignificant racial disparities are present in adverse events among patients in the non-OUD group, but those disparities attenuated in the OUD group.