The following is a summary of “Time trends in opioid use for patients undergoing hip fracture surgery in 1997–2018: A Danish population-based cohort study,” published in the April 2024 issue of Pain by Melsen et al.

Opioids are being used in managing patients with hip fracture surgical pain. Still, no studies have verified opioid use changes over the last two decades. 

Researchers conducted a retrospective study describing time trends in opioid use in patients undergoing first-time hip fracture surgery between 1997-2018.

They identified opioid-naïve hip fracture patients with an age > 55 years old from Danish medical databases (n = 115,962). Opioid use after surgery was looked at in two-year periods to calculate prevalence rates (PR). Moreover, PR was compared to 1997–1998, and corresponding prevalence rate ratios (PRR) were found. Rates of each quarter were used to calculate rate ratios and median morphine milligram equivalents (MME) for each quarter. 

The results showed that in Q1, opioid use PR rose from 29% (1997–1998) to 78% (2017–2018), with a PRR of 2.7 (CI: 2.6–2.8). In Q4, PR was 15% (1997-1998) and peaked in 2003–2004, then decreased but remained high at 13% (2017–2018). Median MME did not increase comparing 2017–2018 to 1997–1998. Tramadol, frequently used in 1997-1998, shifted to oxycodone in 2017-2018.

Investigators concluded that opioid use in Q1 has significantly increased. This change has not led to increased use for up to 1 year. However, continuous attention to opioid tapering, dosage, and safer opioid choices is needed. 

Source: onlinelibrary.wiley.com/doi/full/10.1002/ejp.2271