Citation

Allen MK, Parrish JM, Vakharia R, Kaplan JRM, Vulcano E, Roche MW, Aiyer AA. Foot Ankle Spec. 2020; ePub(ePub): ePub.

Affiliation

Department of Orthopedic Surgery, University of Miami Hospital, Miami, Florida.

Copyright

(Copyright © 2020, SAGE Publishing)

DOI

10.1177/1938640020914715

PMID

32270705

Abstract

BACKGROUND: Ankle fractures are common and may require open reduction and internal fixation (ORIF). Literature is scarce evaluating the associations of opioid use disorder (OUD) with ORIF postoperative outcomes. This study investigates whether OUD patients have increased (1) costs of care, (2) emergency room visits, and (3) readmission rates.

METHODS: ORIF patients with a 90-day history of OUD were identified using an administrative claims database. OUD patients were matched (1:4) to controls by age, sex, and medical comorbidities. The Welch t-test determined the significance of cost of care. Logistic regression yielded odds ratios (ORs) for emergency room visits and 90-day readmission rates.

RESULTS: A total of 2183 patients underwent ORIF (n = 485 with OUD vs n = 1698 without OUD). OUD patients incurred significantly higher costs of care compared with controls ($5921.59 vs $5128.22, P <.0001). OUD patients had a higher incidence and odds of emergency room visits compared with controls (3.50% vs 0.64%; OR = 5.57, 95% CI = 2.59-11.97, P <.0001). The 90-day readmission rates were not significantly different between patients with and without OUD (8.65% vs 7.30%; OR = 1.20, 95% CI = 0.83-1.73, P =.320).

CONCLUSION: OUD patients have greater costs of care and odds of emergency room visits within 90 days following ORIF. Levels of Evidence: Level III: Retrospective cohort study.

Language: en

Keywords

ankle injuries; external and internal fixation; hospital practice; medical-legal issues in pain management; pain management