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논문 기본 정보

자료유형
학술저널
저자정보
Yoo Jun-Il (Department of Orthopaedic Surgery Gyeongsang National University Hospital Jinju Korea.) Jang Suk-Yong (Department of Healthcare Management Graduate School of Public Health Yonsei University Seoul Korea.) Cha Yonghan (Department of Orthopaedic Surgery Eulji University Hospital Daejeon Korea.) Park Chan Ho (Department of Orthopaedic Surgery Yeungnam University Medical Center Daegu Korea.) Kim Jung-Taek (Department of Orthopaedic Surgery Ajou Medical Center Suwon Korea.) Oh Seunghak (Department of Orthopaedic Surgery Eulji University Hospital Daejeon Korea.) Choy Wonsik (Department of Orthopaedic Surgery Eulji University Hospital Daejeon Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.36 No.19
발행연도
2021.1
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1 - 11 (11page)

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Background: The purpose of our study was to assess the use of opioids before and after hip fracture in elderly patients in order to determine the effect of opioid use on all-cause mortality, and to analyze how the history of opioid use before fracture increases the risk of sustained use following hip fracture using a Korea nationwide cohort. Methods: Our study identified hip fracture patients from the Korean National Health Insurance Service-Senior cohort. The index date was defined as 90-days after admission to the acute care hospital that fulfilled the eligibility criteria of elderly hip fracture. Patients were classified into past user, current user, and sustained user according to the use of opioid at each period based on the time of admission and index date. The opioids were classified into strong opioids and tramadol. A generalized estimating equation model with a Poisson distribution and logarithmic link function was performed to estimate the adjusted rate ratios (aRRs) and 95% confidence intervals (CIs) to assess the association between past use and sustained use. A multivariable-adjusted Cox proportional hazard model was used to investigate the effects of strong opioid and tramadol use on all-cause mortality. Results: A total of 12,927 patients were included in our study. There were 7,384 (57.12%) opioid past-users, 11,467 (88.71%) opioid current-users, and 7,172 (55.48%) sustained users. In comparison of the death risk according to current use or the defined daily dose of the opioids or past opioid use, there were no significant differences in the adjusted hazard ratio for death in all groups, compared to the current non-users (P > 0.05). Among survivors 1 year after hip fracture, opioid past-use increased the risk of opioid sustained use by 1.52-fold (aRR; 95% CI, 1.45–1.8; P < 0.001). Conclusion: Current use and past use of opioid did not increase all-cause mortality after hip fracture in elderly patients over 65 years of age. Past use of opioid before hip fracture increased risk of sustained use of opioid compared to the current opioid used without past use.
#Opioid #Mortality #Addiction #Elderly #Hip Fracture #Nationwide Cohort Study

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참고문헌 (32)

참고문헌 신청
Cha YH / 2017 / Effect of causes of surgical delay on early and late mortality in patients with proximal hip fracture / Arch Orthop Trauma Surg 137(5):625~630 google schola A'Court J / 2017 / Pain and analgesia requirements with hip fracture surgery / Orthop Nurs 36(3):224~228 google schola 장석용 / 2019 / Acute Cholecystitis in Elderly Patients after Hip Fracture: a Nationwide Cohort Study / Journal of Korean Medical Science 34(5):1~9 dbpia Fabi DW / 2016 / Multimodal analgesia in the hip fracture patient / J Orthop Trauma 30(Suppl 1):S6~S11 google schola Flanagan CD / 2017 / Traumatic orthopaedic injury is not an independent risk factor for high postdischarge opioid consumption / J Am Acad Orthop Surg Glob Res Rev 1(8):e058 google schola

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