title: Opioid-Based Analgesia: Impact on Total Joint Arthroplasty.
abstract: The objective of this study was to characterize the impact of opioid-based analgesia in total joint arthroplasty. The primary outcomes were incidence of in-hospital complications, length of stay, and discharge destination. Six hundred and seventy-three primary total hip and knee arthroplasties were retrospectively reviewed. The incidence of opioid-related adverse drug events was 8.5%, which accounted for 58.2% of all postoperative complications. Age, anesthesia technique, ASA score, and surgery type were significant risk factors for complications. After adjusting for these confounders, opioid-related adverse drug events were significantly associated with increased length of stay (P < 0.001) and discharge to extended care facilities (P = 0.014).
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Mohamad J
authors.initials: MJ
authors.lastname: Halawi
authors.affiliation: Duke University School of Medicine, Durham, North Carolina.
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: Vovos
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina.
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Green
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Wellman
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: David E
authors.initials: DE
authors.lastname: Attarian
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bolognesi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D010351:Patient Discharge; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: analgesia; arthroplasty; complications; discharge destination; length of stay; opioids