The Impact of Chronic Opioid Use on Trauma Outcomes

Elkbuli, Adel; Narvel, Raed Ismail; Boneva, Dessy; McKenney, Mark

doi:10.1177/000313482008600119

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…Research on the use and adverse outcomes of opioids is an emerging theme in developed countries [1][2][3][4][5][6][7]. Surgical and trauma patients have been a focal point in international studies on opioid use, mostly from the United States (US) [1,8,9].…”

Section: Introductionmentioning

confidence: 99%

Identifying Surgical and Trauma Patients in New Zealand for Opioid-Related Pharmacoepidemiological Research: A Descriptive Study

Gong

Chan

Beyene

et al. 2022

Pharmacoepidemiology

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Unique aspects of New Zealand’s (NZ) health system allow for a novel pharmacoepidemiologic approach to conducting population-based clinical research. A defined cohort of surgical and trauma patients would facilitate future studies into opioid utilisation, outcomes, and other questions related to surgery and trauma. We aimed to describe all patients admitted to a NZ hospital with trauma or to undergo surgery between 1 January 2007 to 31 December 2019. This was a retrospective population-based study involving all hospital centres in NZ. We excluded patients with hospitalisation episodes for surgery or trauma one year before the event. We identified 1.78 million surgical only patients, 633,386 trauma only, and 250,800 trauma with surgery patients. Trauma only patients had the highest prevalence of death within one year of event (17.8%), history of opioid dispensing (18.3%), mental health disorders (17.0%) and chronic pain (2.3%). Moreover, trauma patients also had the highest prevalence of those with higher comorbidity burden. We plan to use this dataset for future research into the prevalence and outcomes of persistent opioid use, and to make our dataset available to other researchers upon request. Our findings of significant differences between cohorts suggest studies should treat surgical and trauma patients separately.

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Section: Introductionmentioning

confidence: 99%

Identifying Surgical and Trauma Patients in New Zealand for Opioid-Related Pharmacoepidemiological Research: A Descriptive Study

Gong

Chan

Beyene

et al. 2022

Pharmacoepidemiology

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“…5,6 While chronic opioid use is associated with an increase in mortality, higher risk of injury, and poor wound healing, current literature is incomplete regarding the impact of opioid use in the trauma setting. 7 When opioids are prescribed, the Centers for Disease Control and Prevention recommends starting with an immediate release form at the lowest effective dose. Increasing the dose ≥90 morphine milligram equivalents (MMEs) per day should be avoided.…”

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confidence: 99%

“…The annual economic impact of prescription opioid misuse in the United States has been estimated by the Centers for Disease Control and Prevention to be $78.5 billion 5,6 . While chronic opioid use is associated with an increase in mortality, higher risk of injury, and poor wound healing, current literature is incomplete regarding the impact of opioid use in the trauma setting 7 …”

mentioning

confidence: 99%

Postoperative opioid prescribing practices in US adult trauma patients: A systematic review

Rowe

Zagales

Fanfan

et al. 2021

J Trauma Acute Care Surg

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BACKGROUND:Opioids have been proven effective in pain management, but overprescription can lead to addiction and abuse. Although current guidelines regarding opioid prescription for chronic and acute pain are available, they fail to address the use of opioids for pain management in traumatic injury patients who undergo operations. The primary objective of this study was to examine opioid prescribing practices for US adult trauma patients who require surgical management, based on prior history of opioid use, type of surgical practice, and age. METHODS:PubMed and Cochrane Journals were used to identify relevant articles between October 2010 and December 29, 2020. Our primary outcome was discrepancies of morphine milligram equivalents (MMEs) prescribed to trauma patients. Significance was defined as p < 0.05. RESULTS:Eleven studies on US trauma patients prescribed opioids were evaluated, creating a total of 30,249 patients stratified by prior opioid use, age, and race. Patterns seen among patients with prior opioid use include higher MMEs prescribed, lower likelihoods of opioid discontinuation, higher mortality rates, and higher complication rates. Orthopedic surgeons prescribed higher values of MMEs than nonorthopedic surgeons. CONCLUSION:Higher incidences of opioid prescriptions are seen with orthopedic trauma surgery and prior opioid use by the patient. We recommend further development of national protocol implementation for acute pain management for the US trauma population.

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The Impact of Chronic Opioid Use on Trauma Outcomes

Cited by 2 publications

References 4 publications

Identifying Surgical and Trauma Patients in New Zealand for Opioid-Related Pharmacoepidemiological Research: A Descriptive Study

Identifying Surgical and Trauma Patients in New Zealand for Opioid-Related Pharmacoepidemiological Research: A Descriptive Study

Postoperative opioid prescribing practices in US adult trauma patients: A systematic review

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