Table 2.
| Characteristic | Total cohort (%) | Drug modality‡ (%) |
|||
|---|---|---|---|---|---|
| Opioids | Opioids + NSAID | Opioids + aceta§ | Opioids + NSAID + aceta§ | ||
| Academic hospital | |||||
| No. (%) | 7893 | 1921 (24.34) | 375 (4.75) | 4779 (60.55) | 818 (10.36) |
| Type of surgery—no. (%) | |||||
| Distal radial fracture | 735 (9.31) | 234 (31.84) | 2 (0.27) | 491 (66.53) | 10 (1.36) |
| Mastectomy | 1049 (13.29) | 117 (11.15) | 7 (0.67) | 897 (85.51) | 28 (2.67) |
| Knee replacement | 3422 (43.35) | 951 (27.79) | 304 (8.88) | 1621 (47.37) | 546 (15.96) |
| Thoracotomy | 2687 (34.04) | 619 (23.04) | 62 (2.31) | 1772 (65.95) | 234 (8.71) |
| Pain at discharge—no. (%) | |||||
| Low pain (0–5) | 6738 (88.24) | 1599 (23.73) | 328 (4.87) | 4093 (60.75) | 718 (10.66) |
| High pain (6–10) | 898 (11.76) | 268 (29.84) | 40 (4.45) | 521 (58.02) | 69 (7.68) |
| Days to first follow-up‖—no. (%) | |||||
| 0–30 d | 4397 (85.78) | 1129 (25.68) | 171 (3.89) | 2753 (62.61) | 344 (7.82) |
| 31–45 d | 729 (14.22) | 243 (33.33) | 31 (4.25) | 387 (53.09) | 68 (9.33) |
| Length of stay–d | 6.60 (±14.25) | 7.81 (±21.13) | 4.30 (±8.12) | 6.75 (±12.08) | 3.95 (±3.87) |
| Inpat. oral morphine equivalence¶ —mg/d | 60.33 (±70.13) | 73.56 (±84.53) | 60.31 (±53.69) | 55.76 (±65.97) | 55.93 (±58.27) |
| Preoperative pain score# | 2.74 (±3.28) | 3.22 (±3.30) | 4.08 (±3.50) | 2.44 (±3.21) | 2.57 ( ±.27) |
| Discharge oral morphine equivalence **—mg/d | 72.40 (±63.81) | 86.00 (±86.18) | 85.02`(±58.02) | 67.70 (±53.81) | 78.07 (±50.56) |
| Opioid naïve | |||||
| Yes | 5465 (70.06) | 1184 (21.67) | 275 (5.03) | 3352 (61.34) | 654 (11.97) |
| No | 2336 (29.94) | 714 (30.57) | 96 (4.11) | 1376 (58.90) | 150 (6.42) |
| Veterans health data | |||||
| No. (%) | 34,581 | 6504 (18.81) | 1847 (5.34) | 18,943 (54.78) | 7287 (21.07) |
| Type of surgery—no. (%) | |||||
| Distal radial fracture | 819 (2.37) | 167 (20.39) | 9 (1.10) | 595 (72.65) | 48 (1.36) |
| Mastectomy | 701 (2.03) | 113 (16.12) | 7 (1.00) | 552 (78.74) | 29 (4.14) |
| Knee replacement | 25,939 (75.01) | 4491 (17.31) | 1553 (5.99) | 13,613 (52.48) | 6282 (24.22) |
| Thoracotomy | 7122 (20.60) | 1733 (24.33) | 278 (3.90) | 4183 (58.73) | 928 (13.03) |
| Pain at discharge—no. (%) | |||||
| Low pain (0–5) | 25,985 (75.14) | 4678 (18.00) | 1279 (4.92) | 14,562 (56.04) | 5466 (21.04) |
| High pain (6–10) | 8596 (24.86) | 1826 (21.24) | 568 (6.61) | 4381 (50.97) | 1821 (21.18) |
| Days to first follow-up§–no. (%) | |||||
| 0–30 d | 21,751 (62.90) | 4117 (18.93) | 1008 (4.63) | 12,503 (57.48) | 4123 (18.96) |
| 31–45 d | 12,830 (37.10) | 2387 (18.60) | 839 (6.54) | 6440 (50.19) | 3164 (24.66) |
| Length of stay—d | 6.48 (±8.35) | 7.34 (±8.98) | 6.40 (±8.62) | 6.41 (±8.05) | 5.89 (±8.33) |
| Inpat. oral morphine equivalence ‖—mg/d | 60.50 (±55.45) | 72.94 (±68.04) | 76.40 (±68.40) | 54.29 (±47.37) | 61.65 (±55.93) |
| Preoperative pain score¶ | 3.80 (±3.32) | 3.92 (±3.31) | 4.18 (±3.30) | 3.63 (±3.34) | 4.04 (±3.26) |
| Discharge oral morphine equivalence#—mg/d | 45.24 (±46.42) | 60.51 (±73.46) | 58.30 (±54.78) | 40.16 (±35.81) | 41.52 (±31.40) |
| Opioid naïve | |||||
| Yes | 22,223 (64.12) | 3899 (17.58) | 1186 (5.35) | 12,307 (55.48) | 4789 (21.59) |
| No | 12,438 (35.88) | 2605 (21.01) | 661 (5.33) | 6636 (53.52) | 2498 (20.15) |
*
Plus-minus values are means ± SD.
†
Significant at P < 0.05 unless stated otherwise.
‡
Drug modality-drug combination regime provided at discharge.
§
Aceta–acetaminophen.
‖
Days until first follow-up visit.
¶
Calculated average oral morphine equivalence in milligrams during the inpatient stay.
#
Preoperative pain score.
**
Calculated average oral morphine equivalence in milligrams given at discharge.