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The following is a summary of “Identifying factors associated with persistent opioid use after total joint arthroplasty: a retrospective review,” published in the November 2024 issue of Pain by Quaye et al. 

Researchers conducted a retrospective study to identify factors predicting persistent opioid use in opioid-naïve individuals after total joint arthroplasty. 

They employed Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression to develop a predictive model for persistent opioid use after surgery. Data was sourced from a U.S. Electronic Health Record dataset formatted in the Observational Medical Outcomes Partnership Common Data Model, 75% of the dataset was allocated for building the LASSO model using 10-fold cross-validation, while the remaining 25% was employed to determine the optimal probability threshold for predicting the binary outcome. 

The results showed that among 6,432 patients, 12.3% (792) had persistent opioid use, defined as at least 1 opioid prescription between 90 days and 1-year post-surgery. Persistent opioid use was associated with current smoking (OR 1.65), antidepressant use (OR 1.76), post-traumatic stress disorder (OR 2.07), and substance-related disorders (OR 1.69). Additional risk factors included back pain (OR 1.43), dementia (OR 1.65), and a body mass index over 40 (OR 2.50). No significant associations were found between persistent opioid use and age, sex, or ethnicity. 

Investigators concluded the predictive model for persistent opioid use after total joint arthroplasty could identify high-risk patients preoperatively, enabling targeted interventions to reduce postoperative opioid reliance. 

Source: academic.oup.com/painmedicine/advance-article-abstract/doi/10.1093/pm/pnae120/7905485