Table 1.
Characteristics of Medicare beneficiaries initiating tramadol, oxycodone, or hydrocodone after total hip and knee arthroplasty
| Characteristic | Tramadol (n = 2,697) | Oxycodone (n = 11,407) | Hydrocodone (n = 14,665) |
|---|---|---|---|
| Age, y, n (%) | |||
| 65–74 | 1,414 (52.4) | 7,709 (67.6) | 9,143 (62.3) |
| 75–84 | 1,097 (40.7) | 3,389 (29.7) | 5,007 (34.1) |
| 85 + | 186 (6.9) | 309 (2.7) | 515 (3.5) |
| Female | 1,890 (70.1) | 6,142 (53.8) | 8,470 (57.8) |
| Race/ethnicity, n (%) | |||
| Non-Hispanic White | 2,508 (93.0) | 10,349 (90.7) | 13,423 (91.5) |
| Non-Hispanic Black | 56 (2.1) | 413 (3.6) | 363 (2.5) |
| Hispanic | 69 (2.6) | 283 (2.5) | 512 (3.5) |
| Other | 64 (2.4) | 362 (3.2) | 367 (2.5) |
| Dual-eligible, n (%) | 136 (5.0) | 699 (6.1) | 974 (6.6) |
| THA, n (%) | 940 (34.9) | 3,216 (28.2) | 4,076 (27.8) |
| TKA, n (%) | 1,757 (65.1) | 8,191 (71.8) | 10,589 (72.2) |
| Discharge disposition, n (%) | |||
| Home | 1,002 (37.2) | 3,538 (31.0) | 5,446 (37.1) |
| Home with HH | 1,695 (62.8) | 7,869 (69.0) | 9,219 (62.9) |
| Comorbidities, n (%) | |||
| Alcohol use disorder | 27 (1.0) | 145 (1.3) | 133 (0.9) |
| Tobacco use | 97 (3.6) | 545 (4.8) | 674 (4.6) |
| Cancer | 394 (14.6) | 1,600 (14.0) | 1,907 (13.0) |
| Dementia | 109 (4.0) | 302 (2.6) | 451 (3.1) |
| AMI | 75 (2.8) | 266 (2.3) | 334 (2.3) |
| AFib | 324 (12.0) | 1,204 (10.6) | 1,471 (10.0) |
| HF | 452 (16.8) | 1,475 (12.9) | 2,022 (13.8) |
| Hypertension | 2,172 (80.5) | 9,180 (80.5) | 11,779 (80.3) |
| Ischemic Heart Disease | 1,127 (41.8) | 4,428 (38.8) | 5,840 (39.8) |
| Stroke/TIA | 239 (8.9) | 759 (6.7) | 1,053 (7.2) |
| Liver disease | 147 (5.5) | 548 (4.8) | 681 (4.6) |
| CKD | 396 (14.7) | 1,514 (13.3) | 1,776 (12.1) |
| Asthma | 308 (11.4) | 1,132 (9.9) | 1,399 (9.5) |
| COPD | 417 (15.5) | 1,565 (13.7) | 2,118 (14.4) |
| Combined Comorbidity Score, n (%) | |||
| < 0a | 531 (19.7) | 2,619 (23.0) | 3,402 (23.2) |
| 0 | 764 (28.3) | 3,436 (30.1) | 4,541 (31.0) |
| 1 | 588 (21.8) | 2,324 (20.4) | 2,962 (20.2) |
| 2 | 345 (12.8) | 1,351 (11.8) | 1,729 (11.8) |
| 3 + | 469 (17.4) | 1,677 (14.7) | 2,031 (13.8) |
| Claims-based Frailty Index,b n (%) | |||
| Robust | 1,805 (66.9) | 8,225 (72.1) | 10,343 (70.5) |
| Prefrail, Mildly Frail, or Moderately-to-severely Frailc | 892 (33.1) | 3,182 (27.9) | 4,322 (29.5) |
Abbreviations: THA total hip arthroplasty, TKA total knee arthroplasty, HH home health, AMI acute myocardial infarction, AFib atrial fibrillation, HF heart failure, TIA transient ischemic attack, CKD chronic kidney disease, COPD chronic obstructive pulmonary disease
aCombined Comorbidity Score values that are less than 0 are possible due to a component value of -1 in the algorithm for HIV/AIDS and Hypertension
bMeasured using the Claims-based Frailty Index and categorized as: < 0.15 (robust), 0.15–0.24 (prefrail), 0.25–0.34 (mildly frail), and ≥ 0.35 (moderately-to-severely frail)
cCategories combined to avoid violating the Centers for Medicare and Medicaid Services Cell Size Suppression Policy