Prior Diagnosis of Opioid Related Disorder is Associated with Higher Medical Resource Utilization Following Primary Hip Arthroscopy: A National Database Study
Peter F. Monahan, Serkan Surucu, Natalie K. Pahapill, Andrew E. Jimenez, Kenneth F. Taylor
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Abstract
Purpose
To compare adverse events, medical resource utilization, prescribing patterns and revision surgery rates of patients with opioid related disorders (ORD) undergoing primary hip arthroscopy against a propensity matched group with no opioid related disorders (NORD).
Methods
The TriNetX database was queried between January 2015 and December 2020 using ICD-10 and CPT codes to identify patients undergoing primary hip arthroscopy between ages 18 and 70. The ORD cohort was propensity matched in a 1:1 ratio to NORD patients based on age, sex, alcohol related disorders, heart disease, hypertension, metabolic disorders, anxiety disorders, major depressive disorder, diabetes mellitus, and anti-depressant prescriptions. Postoperative rates of adverse events and medical resources were compared within 90 days of procedure, prescriptions were compared within 1 year, and revision surgery were compared within 2 years.
Results
A total of 809 ORD patients were propensity matched in a 1:1 ratio to NORD patients. Postoperative adverse events were similar between groups (P = .693). Rates of revision arthroscopy were also similar for both ORD (9.3%) and NORD (8.0%) cohorts (OR: 1.17 [95% CI 0.83-1.66]; P = .377). ORD patients received care from the emergency department, inpatient admission, outpatient visit, and physical therapy evaluations at higher rates. The ORD cohort received a greater amount of new opioid (OR: 2.66 [95% CI 2.17-3.26]; P < .0001) and antidepressant prescriptions (OR: 1.58 [95%CI 1.26 -1.97]; P < .0001) compared to NORD patients within 1 year of surgery.
Conclusion
ORD patients demonstrated similar rates of adverse events and revision surgery when compared to a propensity matched group of NORD patients undergoing primary hip arthroscopy. However, ORD patients experienced increased rates of ED visits, hospitalizations and were prescribed higher rates of opioid and antidepressant prescriptions.
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