Osteoarthritis and Cartilage ( IF 7.2 ) Pub Date : 2022-07-30 , DOI: 10.1016/j.joca.2022.07.006 A N Klenø 1 , H T Sørensen 1 , A B Pedersen 1
Objective
To examine time trends in the use of NSAIDs and opioids for patients with osteoarthritis undergoing total hip arthroplasty (THA) during 1996–2018.
Method
Using Danish population-based medical databases, we identified 103,209 THA patients. Prevalence rates of NSAID and opioid use among preoperative users and non-users were calculated in four quarters (Q1-Q4) after THA by calendar periods (1996–2000, 2001–2006, 2007–2012 and 2013–2018). Prevalence rate ratios (PRR) were adjusted for age and gender.
Results
Among preoperative NSAID users and non-users, NSAID use in Q1 increased from 32.6% in 1996–2000 to 48.0% in 2013–2018 (PRR = 1.49, 95% CI: 1.42–1.55) and from 12.9% to 32.0% (PRR = 2.49 (2.32–2.67)), respectively. Among preoperative opioid users and non-users, opioid use in Q1 increased from 42.7% in 1996–2000 to 76.9% in 2013–2018 (PRR = 1.81 (1.73–1.89)) and from 15.2% to 58.2% (PRR = 3.85 (3.65–4.05)), respectively. NSAID use in Q4 decreased from 24.5% in 1996–2000 to 21.4% in 2013–2018 (PRR = 0.88 (0.83–0.93)) and from 6.9% to 5.6% (PRR = 0.81 (0.73–0.91)) in preoperative NSAIDs users and non-users, respectively. Opioid use in Q4 increased from 26.6% in 1996–2000 to 28.6% (PRR = 1.08 (1.02–1.15)) in 2013–2018 and from 4.1% to 5.0% (PRR = 1.25 (1.11–1.40)) in preoperative opioid users and non-users, respectively.
Conclusion
We observed up to a 4-fold increase in NSAID and opioid use in Q1 during 1996–2018, while usage in Q4 did not change substantially. However, 5–6% of the preoperative non-users of NSAIDs and opioids were users in Q4, which might relate to inaccurate indication for or timing of THA and the post-surgical phasing out of analgesics use.
中文翻译:
1996-2018 年间因骨关节炎进行全髋关节置换术后一年使用非甾体类抗炎药和阿片类药物的时间趋势:103,209 名患者的基于人群的队列研究
客观的
研究 1996-2018 年间接受全髋关节置换术 (THA) 的骨关节炎患者使用 NSAID 和阿片类药物的时间趋势。
方法
使用丹麦基于人群的医学数据库,我们确定了 103,209 名 THA 患者。按日历期(1996-2000、2001-2006、2007-2012 和 2013-2018)计算 THA 后四个季度(Q1-Q4)术前使用者和非使用者中 NSAID 和阿片类药物使用的流行率。患病率比(PRR)根据年龄和性别进行了调整。
结果
在术前 NSAID 使用者和非使用者中,第一季度 NSAID 的使用率从 1996-2000 年的 32.6% 增加到 2013-2018 年的 48.0%(PRR = 1.49,95% CI:1.42-1.55)和从 12.9% 增加到 32.0%(PRR = 2.49 (2.32–2.67)),分别。在术前阿片类药物使用者和非使用者中,第一季度阿片类药物使用率从 1996-2000 年的 42.7% 增加到 2013-2018 年的 76.9%(PRR = 1.81 (1.73-1.89))和从 15.2% 增加到 58.2%(PRR = 3.85 ( 3.65–4.05)),分别。第 4 季度的 NSAID 使用率从 1996-2000 年的 24.5% 降至 2013-2018 年的 21.4%(PRR = 0.88 (0.83-0.93)),术前 NSAIDs 使用者从 6.9% 降至 5.6%(PRR = 0.81 (0.73-0.91))和非用户,分别。第四季度的阿片类药物使用率从 1996-2000 年的 26.6% 增加到 2013-2018 年的 28.6% (PRR = 1.08 (1.02-1.15)),术前阿片类药物使用者从 4.1% 增加到 5.0% (PRR = 1.25 (1.11-1.40))和非用户,分别。
结论
我们观察到 1996-2018 年第一季度非甾体抗炎药和阿片类药物的使用量增加了 4 倍,而第四季度的使用量没有实质性变化。然而,5-6% 的术前非 NSAIDs 和阿片类药物使用者是第四季度的使用者,这可能与 THA 的指征或时机不准确以及镇痛剂的术后逐步停用有关。