Abstract
Background
There is currently a knowledge gap regarding persistent opioid use after hip fracture surgery. Thus, opioid use within a year after hip fracture surgery in patients with/without opioid use before surgery was examined.
Methods
This population‐based cohort study included all patients (aged≥65) undergoing primary hip fracture surgery in Denmark (2005‐2015) identified from the Danish Multidisciplinary Hip Fracture Database. Opioid use was assessed from The Danish National Health Service Prescription Database as redeemed prescriptions. The proportion of patients with ≥1 opioid prescription was computed within six‐month before surgery and each of four three‐month periods (quarters) after surgery, among patients alive first day in each period. Proportion differences (95%CI) were calculated for each quarter compared to before surgery. Proportions were calculated for users and non‐users before surgery, including initiators after first quarter.
Results
This study included 69,456 patients. Proportion differences of opioid users were 35.0 (95%CI 34.5‐35.5), 7.0 (95%CI 6.5‐7.5), 2.9 (95%CI 2.4‐3.4), and 1.4 percentage‐points (95%CI 0.9‐1.9) the four quarters after surgery compared to before. Among opioid non‐users before surgery, 54.7% (95%CI 54.3‐55.1) 21.8% (95%CI 21.4‐22.2), 17.8% (95%CI 17.4‐18.2), and 16.8% (95%CI 16.4‐17.2) were opioid users in 1st‐4th quarter after surgery. However, 8.5% (95%CI 8.2‐8.7) of the non‐users before surgery in 4th quarter initiated opioid use more than a quarter after surgery.
Conclusions
The proportion of opioid users increased after hip fracture surgery and was 1.4 percentage‐points increased in fourth quarter compared to before. Of opioid non‐users before surgery, 16.8% were opioid users fourth quarter after surgery.
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