Table 1.
Demographic and clinical variables of cohort (N = 44,247)
| Characteristics | Overall | Total OME from 30 days prior to 30 days after surgery | |||||||
|---|---|---|---|---|---|---|---|---|---|
| < 150 | 150–225 | ≥ 225 | p value | ||||||
| N | % | N | % | N | % | N | % | ||
| Age, years | < 0.001 | ||||||||
| 65–69 | 11,857 | 26.8 | 3974 | 23.5 | 3110 | 26.3 | 4773 | 30.9 | |
| 70–74 | 12,923 | 29.2 | 4738 | 28.0 | 3399 | 28.7 | 4786 | 31.0 | |
| 75–79 | 9414 | 21.3 | 3690 | 21.8 | 2558 | 21.6 | 3166 | 20.5 | |
| 80–84 | 6209 | 14.0 | 2695 | 15.9 | 1726 | 14.6 | 1788 | 11.6 | |
| ≥ 85 | 3844 | 8.7 | 1846 | 10.9 | 1055 | 8.9 | 943 | 6.1 | |
| Gender | < 0.001 | ||||||||
| Male | 26,071 | 58.9 | 9231 | 54.5 | 7123 | 60.1 | 9717 | 62.9 | |
| Female | 18,176 | 41.1 | 7712 | 45.5 | 4725 | 39.9 | 5739 | 37.1 | |
| Race | < 0.001 | ||||||||
| White | 39,430 | 89.1 | 15,130 | 89.3 | 10,609 | 89.5 | 13,691 | 88.6 | |
| Black | 1514 | 3.4 | 529 | 3.1 | 358 | 3.0 | 627 | 4.1 | |
| Hispanic | 1818 | 4.1 | 728 | 4.3 | 457 | 3.9 | 633 | 4.1 | |
| Other | 1293 | 2.9 | 499 | 3.0 | 370 | 3.1 | 424 | 2.7 | |
| Missing | 192 | 0.4 | 57 | 0.3 | 54 | 0.5 | 81 | 0.5 | |
| Resided in metropolitan county | < 0.001 | ||||||||
| Yes | 31,174 | 70.5 | 12,009 | 70.9 | 8143 | 68.7 | 11,022 | 71.3 | |
| No | 13,008 | 29.4 | 4910 | 29.0 | 3687 | 31.1 | 4411 | 28.5 | |
| Missing | 65 | 0.2 | 24 | 0.1 | 18 | 0.2 | 23 | 0.2 | |
| Division | < 0.001 | ||||||||
| East North Central | 4965 | 11.2 | 1899 | 11.2 | 1302 | 11.0 | 1764 | 11.4 | |
| East South Central | 2039 | 4.6 | 756 | 4.5 | 527 | 4.5 | 756 | 4.9 | |
| Middle Atlantic | 3459 | 7.8 | 1286 | 7.6 | 843 | 7.1 | 1330 | 8.6 | |
| Mountain | 3898 | 8.8 | 1432 | 8.5 | 1113 | 9.4 | 1353 | 8.8 | |
| New England | 6828 | 15.4 | 2728 | 16.1 | 1856 | 15.7 | 2244 | 14.5 | |
| Pacific | 2181 | 4.9 | 745 | 4.4 | 663 | 5.6 | 773 | 5.0 | |
| South Atlantic | 7116 | 16.1 | 2716 | 16.0 | 1711 | 14.4 | 2689 | 17.4 | |
| West North Central | 3507 | 7.9 | 1332 | 7.9 | 788 | 6.7 | 1387 | 9.0 | |
| West South Central | 4304 | 9.7 | 1602 | 9.5 | 1261 | 10.6 | 1441 | 9.3 | |
| Unknown | 5950 | 13.5 | 2447 | 14.4 | 1784 | 15.1 | 1719 | 11.1 | |
| Charlson Comorbidity Index | 0.026 | ||||||||
| None (CCI 0) | 16,062 | 36.3 | 6118 | 36.1 | 4332 | 36.6 | 5612 | 36.3 | |
| Mild (CCI 1, 2) | 17,421 | 39.4 | 6563 | 38.7 | 4723 | 39.9 | 6135 | 39.7 | |
| Moderate (CCI 3, 4) | 7098 | 16.0 | 2780 | 16.4 | 1834 | 15.5 | 2484 | 16.1 | |
| Severe (CCI ≥ 5) | 3666 | 8.3 | 1482 | 8.8 | 959 | 8.1 | 1225 | 7.9 | |
| Medicaid eligibility | 5479 | 12.4 | 1954 | 11.5 | 1395 | 11.8 | 2130 | 13.8 | < 0.001 |
| Any hospitalization in previous year | 4562 | 10.3 | 1865 | 11.0 | 1190 | 10.0 | 1507 | 9.8 | < 0.001 |
| Skilled nursing facility stay in previous year | 561 | 1.3 | 285 | 1.7 | 128 | 1.1 | 148 | 1.0 | < 0.001 |
| History of tobacco use | 3471 | 7.8 | 1230 | 7.3 | 916 | 7.7 | 1325 | 8.6 | < 0.001 |
| Year of surgery | < 0.001 | ||||||||
| 2009 | 6568 | 14.8 | 2585 | 15.3 | 1576 | 13.3 | 2407 | 15.6 | |
| 2010 | 6676 | 15.1 | 2470 | 14.6 | 1666 | 14.1 | 2540 | 16.4 | |
| 2011 | 6753 | 15.3 | 2611 | 15.4 | 1931 | 16.3 | 2211 | 14.3 | |
| 2012 | 7200 | 16.3 | 2774 | 16.4 | 2022 | 17.1 | 2404 | 15.6 | |
| 2013 | 7712 | 17.4 | 2995 | 17.7 | 2083 | 17.6 | 2634 | 17.0 | |
| 2014 | 9338 | 21.1 | 3508 | 20.7 | 2570 | 21.7 | 3260 | 21.1 | |
| Mental health disorders | |||||||||
| Adjustment | 477 | 1.1 | 192 | 1.1 | 133 | 1.1 | 152 | 1.0 | 0.368 |
| Anxiety | 3133 | 7.1 | 1200 | 7.1 | 784 | 6.6 | 1149 | 7.4 | 0.033 |
| Mood | 3650 | 8.3 | 1417 | 8.4 | 918 | 7.8 | 1315 | 8.5 | 0.061 |
| Suicide or self-harm | 34 | 0.1 | 18 | 0.1 | 7 | 0.1 | 9 | 0.1 | 0.213 |
| Disruptive | 97 | 0.2 | 29 | 0.2 | 23 | 0.2 | 45 | 0.3 | 0.055 |
| Personality | 41 | 0.1 | 20 | 0.1 | 8 | 0.1 | 13 | 0.1 | 0.348 |
| Psychosis | 505 | 1.1 | 186 | 1.1 | 132 | 1.1 | 187 | 1.2 | 0.605 |
| Other mental health disorders | 871 | 2.0 | 318 | 1.9 | 238 | 2.0 | 315 | 2.0 | 0.542 |
| Alcohol or substance abuse disorders | 280 | 0.6 | 92 | 0.5 | 68 | 0.6 | 120 | 0.8 | 0.019 |
| Pain disorders | |||||||||
| Arthritis | 27,673 | 62.5 | 11,057 | 65.3 | 7266 | 61.3 | 9350 | 60.5 | < 0.001 |
| Back | 11,411 | 25.8 | 4466 | 26.4 | 3005 | 25.4 | 3940 | 25.5 | 0.095 |
| Neck | 5418 | 12.2 | 2198 | 13.0 | 1412 | 11.9 | 1808 | 11.7 | 0.001 |
| Other pain | 13,182 | 29.8 | 5168 | 30.5 | 3521 | 29.7 | 4493 | 29.1 | 0.019 |
| SHA and opioid filled concurrently during perioperative period | 2129 | 4.8 | 396 | 2.3 | 667 | 5.6 | 1066 | 6.9 | < 0.001 |
| Frailty index | < 0.001 | ||||||||
| Non-frail (FI ≤ 0.1) | 5997 | 13.6 | 2175 | 12.8 | 1665 | 14.1 | 2157 | 14.0 | |
| Pre-frail (0.1 < FI ≤ 0.2) | 33,819 | 76.4 | 12,876 | 76.0 | 9062 | 76.5 | 11,881 | 76.9 | |
| Mildly to severely frail (FI > 0.2) | 4431 | 10.0 | 1892 | 11.2 | 1121 | 9.5 | 1418 | 9.2 | |
OME, oral morphine equivalent; SHA, sedative, hypnotic, or anxiolytic