Opioid use in older orthopedic rehabilitation inpatients: a retrospective study.
Aaron J Bilek, Stephanie Cullen, Carolyn M Tan and 3 others
PMID 36745157WHAT IT FOUND
New opioid users in orthopedic rehab received far lower doses than guidelines suggest, with older patients requiring the least.
Prior users received much higher doses. Functional recovery was similar across groups, but constipation was common in all.
Key findings
01New opioid users received a median of 6.9 mg oral morphine equivalents daily, significantly lower than the 30.3 mg received by prior users.
02Opioid requirements decreased with age among new users, with those aged 85+ receiving a median of 3.4 mg daily compared to 19.4 mg for those aged 50-64.
03Functional outcomes, including FIM change and discharge destination, were similar between prior users, new users, and non-users, despite differences in opioid dose.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Retrospective design limits ability to establish causality between opioid dose and outcomes. Data collection was limited to the first seven days, so long-term pain management and chronic opioid use were not assessed. Pain scores were collected as part of routine care, so variability in provider practice may affect reliability. The study was single-center, which may limit generalizability to other rehabilitation settings. Detailed outpatient prescription history was unavailable, so 'prior user' status was based on admission records.
Declared interests
The protocol was approved by the Mount Sinai Hospital Research Ethics Board. No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that lower opioid doses in new users led to worse pain control or functional outcomes. The study found similar functional recovery and low-to-moderate pain scores across all groups, suggesting that the lower doses were effective for new users.