@article{ref1,
title="Opioid use for a first-incident upper extremity fracture in 220,440 patients without recent prior use in Ontario, Canada: a retrospective cohort study",
journal="OTA international : the open access journal of orthopaedic trauma",
year="2022",
author="Jaglal, Susan and Faber, Kenneth J. and Richards, Lucie and McClure, J. Andrew and Macdermid, Joy C.",
volume="5",
number="3",
pages="e202-e202",
abstract="To describe opioid use for a first upper extremity fracture in a cohort of patients who did not have recent opioid use. <br><br>DESIGN: Descriptive epidemiological study.   SETTING: Emergency Department, Hospital.   PATIENTS/PARTICIPANTS: We obtained health administrative data records of adults presenting with a first adult upper extremity fracture from 2013 to 2017 in Ontario, Canada. We excluded patients with previous fractures, opioid prescription in the past 6 months or hospitalization >5 days after the fracture.   INTERVENTION: Opioid prescription.   MAIN OUTCOME MEASUREMENTS: We identified the proportion of patients filling an opioid prescription within 7 days of fracture. We described this based on different upper extremity fractures (ICD-10), Demographics (age, sex, rurality), comorbidity (Charlson Comorbidity Index, Rheumatoid arthritis, Diabetes), season of injury, and social marginalization (Ontario Marginalization Index-a data algorithm that combines a wide range of demographic indicators into 4 distinct dimensions of marginalization). We considered statistical differences (P<.01) that reached a standardized mean difference of 10% as being clinically important (standardized mean difference [SMD] ≥ 0.1). <br><br>RESULTS: From 220,440 patients with a first upper extremity fracture (50% female, mean age 50), opioids were used by 34% of cases overall (32% in males, 36% in females, P<.001, SMD ≥ 0.1). Use varied by body region, with those with multiple or proximal fractures having the highest use: multiple shoulder 64%, multiple regions 62%, shoulder 62%, elbow 38%, wrist 31%, and hand 21%; and was higher in patients who had a nerve/tendon injury or hospitalization (P<.01, SMD ≥ 0.1). Social marginalization, comorbidity, and season of injury had clinically insignificant effects on opioid use. <br><br>CONCLUSIONS: More than one-third of patients who are recent-non-users will fill an opioid prescription within 7 days of a first upper extremity fracture, with usage highly influenced by fracture characteristics.Level of Evidence: Level II.<p /> <p>Language: en</p>",
language="en",
issn="2574-2167",
doi="10.1097/OI9.0000000000000202",
url="http://dx.doi.org/10.1097/OI9.0000000000000202"
}