Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients.
| Title: | Association between spine injury and opioid misuse in a prospective cohort of Level I trauma patients. |
|---|---|
| Authors: | Tilhou AS; Department of Family Medicine, Boston University/Boston Medical Center, Boston, MA.; Glass JE; Kaiser Permanente Washington Health Research Group, Seattle, WA.; Hetzel SJ; Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health.; Shana OE; University of Wisconsin School of Medicine and Public Health.; Borza T; Departments of Urology and Surgery, University of Wisconsin School of Medicine and Public Health.; Baltes A; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI.; Deyo BMF; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI.; Agarwal S; Department of Surgery, Duke University, Durham, NC.; O'Rourke A; Department of Surgery, University of Wisconsin School of Medicine and Public Health.; Brown RT; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI. |
| Source: | OTA international : the open access journal of orthopaedic trauma [OTA Int] 2022 Jul 12; Vol. 5 (3). Date of Electronic Publication: 2022 Jul 12 (Print Publication: 2022). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101770383 Publication Model: eCollection Cited Medium: Internet ISSN: 2574-2167 (Electronic) Linking ISSN: 25742167 NLM ISO Abbreviation: OTA Int Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, Pennsylvania : Wolters Kluwer Health, [2018]- |
| Abstract: | Objective: To explore patient and treatment factors explaining the association between spine injury and opioid misuse.; Design: Prospective cohort study.; Setting: Level I trauma center in a Midwestern city.; Participants: English speaking patients aged 18 to 75 on Trauma and Orthopedic Surgical Services receiving opioids during hospitalization and prescribed at discharge.; Exposure: Spine injury on the Abbreviated Injury Scale.; Main Outcome Measures: Opioid misuse was defined by using opioids: in a larger dose, more often, or longer than prescribed; via a non-prescribed route; from someone other than a prescriber; and/or use of heroin or opium. Exploratory factor groups included demographic, psychiatric, pain, and treatment factors. Multivariable logistic regression estimated the association between spine injury and opioid misuse when adjusting for each factor group.; Results: Two hundred eighty-five eligible participants consented of which 258 had baseline injury location data and 224 had follow up opioid misuse data. Most participants were male (67.8%), white (85.3%) and on average 43.1 years old. One-quarter had a spine injury (25.2%). Of those completing follow-up measures, 14 (6.3%) developed misuse. Treatment factors (injury severity, intubation, and hospital length of stay) were significantly associated with spine injury. Spine injury significantly predicted opioid misuse [odds ratio [OR] 3.20, 95% confidence interval [CI] (1.05, 9.78)]. In multivariable models, adjusting for treatment factors attenuated the association between spine injury and opioid misuse, primarily explained by length of stay.; Conclusion: Spine injury exhibits a complex association with opioid misuse that predominantly operates through treatment factors. Spine injury patients may represent a subpopulation requiring early intervention to prevent opioid misuse.; (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.) |
| References: | J Bone Joint Surg Am. 2017 Aug 2;99(15):1247-1252. (PMID: 28763410); Clin J Pain. 2008 Jul-Aug;24(6):497-508. (PMID: 18574359); JAMA Pediatr. 2017 Aug 1;171(8):747-755. (PMID: 28628701); Clin Orthop Relat Res. 2015 Jan;473(1):297-304. (PMID: 25115589); Cochrane Database Syst Rev. 2013 Aug 29;(8):CD006146. (PMID: 23986501); Anaesthesia. 2021 Apr;76(4):520-536. (PMID: 33027841); Ann Surg. 2018 Dec;268(6):985-991. (PMID: 28767563); J Biomed Inform. 2009 Apr;42(2):377-81. (PMID: 18929686); Pain Med. 2014 Sep;15(9):1549-57. (PMID: 24641213); Arch Intern Med. 2006 May 22;166(10):1092-7. (PMID: 16717171); JAMA Surg. 2017 Oct 01;152(10):930-936. (PMID: 28636707); Drug Alcohol Depend. 2022 Mar 1;232:109286. (PMID: 35101814); Ann Surg. 2021 Dec 1;274(6):e957-e965. (PMID: 31714315); J Trauma Acute Care Surg. 2020 Jun;88(6):816-824. (PMID: 32459447); Injury. 2016 Jul;47(7):1393-403. (PMID: 27157986); Spine (Phila Pa 1976). 2014 Dec 1;39(25):E1524-30. (PMID: 25417827); Injury. 2016 Jan;47(1):109-15. (PMID: 26283084); JAMA Netw Open. 2020 Jun 1;3(6):e207367. (PMID: 32584407); Addict Behav. 2012 Mar;37(3):225-33. (PMID: 22143002); Spine (Phila Pa 1976). 2013 Dec 1;38(25):2196-200. (PMID: 24296482); JAMA Surg. 2017 Dec 1;152(12):1175-1176. (PMID: 28813584); BMJ. 2014 Feb 11;348:g1251. (PMID: 24519537); Clin J Pain. 2018 Sep;34(9):878-884. (PMID: 29505419); Am J Ind Med. 2020 Oct;63(10):868-877. (PMID: 32677121); J Trauma Acute Care Surg. 2012 Apr;72(4):975-81. (PMID: 22491614); Arch Phys Med Rehabil. 2018 May;99(5):855-861. (PMID: 29307814); N Engl J Med. 2016 Jan 14;374(2):154-63. (PMID: 26760086); Arch Phys Med Rehabil. 2021 Jan;102(1):35-43. (PMID: 32891422); J Trauma. 1974 Mar;14(3):187-96. (PMID: 4814394); J Bone Joint Surg Am. 2018 Aug 1;100(15):1332-1340. (PMID: 30063596); J Trauma Acute Care Surg. 2012 Apr;72(4):1068-77. (PMID: 22491629); Ann Acad Med Singap. 1994 Mar;23(2):129-38. (PMID: 8080219); Br J Surg. 2020 Mar;107(4):413-421. (PMID: 32031251); Pain Med. 2012 Feb;13(2):150-74. (PMID: 22239747); J Pain. 2017 Aug;18(8):956-963. (PMID: 28347798); Addict Behav. 2016 Jul;58:74-9. (PMID: 26921721); Drug Alcohol Depend. 2017 Oct 1;179:260-266. (PMID: 28818717); J Opioid Manag. 2015 Jul-Aug;11(4):313-8. (PMID: 26312958); J Orthop Sci. 2018 Mar;23(2):273-276. (PMID: 29150193); J Addict. 2014;2014:156954. (PMID: 25506462); J Gen Intern Med. 2001 Sep;16(9):606-13. (PMID: 11556941); Addict Sci Clin Pract. 2017 Dec 4;12(1):28. (PMID: 29198186); Ann Intern Med. 2020 Nov 3;173(9):721-729. (PMID: 32805130) |
| Contributed Indexing: | Keywords: abbreviated injury scale; length of stay; opioid-related disorders; risk factors; spine |
| Entry Date(s): | Date Created: 20221024 Latest Revision: 20231003 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC9575565 |
| DOI: | 10.1097/OI9.0000000000000205 |
| PMID: | 36275837 |
| Database: | MEDLINE |
Journal Article