Table 3.
Opioid use by sex for fracture types and characteristics of the cohort.
| Female | Male | |||||||
|
|
|
|||||||
|---|---|---|---|---|---|---|---|---|
| No Opioid (n = 70111) | Opioid (n = 40302) | P | Standardized Difference | No Opioid (n = 74786) | Opioid (n = 35241) | P | Standardized Difference | |
| Demographics | ||||||||
| Age group, N (%) | ||||||||
| 18–40 years old | 18,104 (25.8%) | 7203 (17.9%) | <.001 | 0.19 | 39,785 (53.2%) | 15,177 (43.1%) | <.001 | 0.2 |
| 41–50 years old | 8009 (11.4%) | 4408 (10.9%) | 0.02 | 11,061 (14.8%) | 6203 (17.6%) | 0.08 | ||
| 51–65 years old | 21,038 (30.0%) | 14,038 (34.8%) | 0.1 | 14,125 (18.9%) | 8652 (24.6%) | 0.14 | ||
| 66–80 years old | 14,339 (20.5%) | 10,040 (24.9%) | 0.11 | 6706 (9.0%) | 3867 (11.0%) | 0.07 | ||
| 81+ years old | 8621 (12.3%) | 4613 (11.4%) | 0.03 | 3109 (4.2%) | 1342 (3.8%) | 0.02 | ||
| Fracture Characteristics, N (%) | ||||||||
| Fracture region | ||||||||
| > 1 region | 1191 (1.7%) | 2067 (5.1%) | <.001 | 0.19 | 1037 (1.4%) | 1596 (4.5%) | <.001 | 0.19 |
| Shoulder | 7092 (10.1%) | 12,450 (30.9%) | 0.53 | 6425 (8.6%) | 9718 (27.6%) | 0.51 | ||
| Elbow | 10,052 (14.3%) | 6519 (16.2%) | 0.05 | 6677 (8.9%) | 4014 (11.4%) | 0.08 | ||
| Forearm & Wrist | 29,552 (42.2%) | 14,714 (36.5%) | 0.12 | 17,944 (24.0%) | 7003 (19.9%) | 0.10 | ||
| Hand | 22,224 (31.7%) | 4552 (11.3%) | 0.51 | 42,703 (57.1%) | 12,910 (36.6%) | 0.42 | ||
| Fracture | ||||||||
| Multiple shoulder | 440 (0.6%) | 918 (2.3%) | <.001 | 0.14 | 426 (0.6%) | 643 (1.8%) | <.001 | 0.12 |
| Clavicle | 1807 (2.6%) | 2031 (5.0%) | 0.13 | 3323 (4.4%) | 4915 (13.9%) | 0.33 | ||
| Scapula | 387 (0.6%) | 349 (0.9%) | 0.04 | 746 (1.0%) | 859 (2.4%) | 0.11 | ||
| Proximal Humerus | 3825 (5.5%) | 7720 (19.2%) | 0.43 | 1568 (2.1%) | 2478 (7.0%) | 0.24 | ||
| Humerus, shaft | 244 (0.3%) | 774 (1.9%) | 0.15 | 151 (0.2%) | 533 (1.5%) | 0.14 | ||
| Humerus, unspecified | 389 (0.6%) | 658 (1.6%) | 0.10 | 211 (0.3%) | 290 (0.8%) | 0.07 | ||
| Radius Head | 5180 (7.4%) | 2090 (5.2%) | 0.09 | 3442 (4.6%) | 1428 (4.1%) | 0.03 | ||
| Distal Humerus | 530 (0.8%) | 654 (1.6%) | 0.08 | 381 (0.5%) | 386 (1.1%) | 0.07 | ||
| Olecranon | 612 (0.9%) | 832 (2.1%) | 0.10 | 750 (1.0%) | 678 (1.9%) | 0.08 | ||
| Coranoid | 184 (0.3%) | 71 (0.2%) | 0.02 | 254 (0.3%) | 75 (0.2%) | 0.02 | ||
| Monteggia | 3 (0.0%) | 18 (0.0%) | 0.03 | 3 (0.0%) | 12 (0.0%) | 0.02 | ||
| Multiple forearm | 2685 (3.8%) | 1393 (3.5%) | 0.02 | 1771 (2.4%) | 872 (2.5%) | 0.01 | ||
| Distal Radius | 17,807 (25.4%) | 11,358 (28.2%) | 0.06 | 6774 (9.1%) | 3978 (11.3%) | 0.07 | ||
| Scaphoid | 4919 (7.0%) | 652 (1.6%) | 0.27 | 4850 (6.5%) | 911 (2.6%) | 0.19 | ||
| Multiple Radius and Ulna | 3543 (5.1%) | 2854 (7.1%) | 0.09 | 1847 (2.5%) | 1435 (4.1%) | 0.09 | ||
| Ulnar Shaft | 424 (0.6%) | 168 (0.4%) | 0.03 | 521 (0.7%) | 222 (0.6%) | 0.01 | ||
| Radius Shaft | 129 (0.2%) | 61 (0.2%) | 0.01 | 99 (0.1%) | 109 (0.3%) | 0.04 | ||
| Ulna and Radial shaft | 46 (0.1%) | 92 (0.2%) | 0.04 | 39 (0.1%) | 91 (0.3%) | 0.05 | ||
| Wrist & Hand | 2123 (3.0%) | 793 (2.0%) | 0.07 | 1677 (2.2%) | 433 (1.2%) | 0.08 | ||
| Other carpal | 1419 (2.0%) | 197 (0.5%) | 0.14 | 2213 (3.0%) | 387 (1.1%) | 0.13 | ||
| D1 MC | 414 (0.6%) | 93 (0.2%) | 0.06 | 965 (1.3%) | 321 (0.9%) | 0.04 | ||
| D2-D5 MC | 6257 (8.9%) | 1290 (3.2%) | 0.24 | 16,085 (21.5%) | 3149 (8.9%) | 0.36 | ||
| Multiple metacarpal | 356 (0.5%) | 132 (0.3%) | 0.03 | 1011 (1.4%) | 391 (1.1%) | 0.02 | ||
| Proximal Phalanx | 1073 (1.5%) | 177 (0.4%) | 0.11 | 1645 (2.2%) | 384 (1.1%) | 0.09 | ||
| Distal Phalanx | 4982 (7.1%) | 1156 (2.9%) | 0.2 | 11,059 (14.8%) | 4495 (12.8%) | 0.06 | ||
| Phalanx, Other | 8414 (12.0%) | 1297 (3.2%) | 0.34 | 10,628 (14.2%) | 2655 (7.5%) | 0.22 | ||
| Multiple Finger | 728 (1.0%) | 407 (1.0%) | 0 | 1310 (1.8%) | 1515 (4.3%) | 0.15 | ||
| Open fracture | 953 (1.4%) | 1170 (2.9%) | <.001 | 0.11 | 3579 (4.8%) | 4623 (13.1%) | <.001 | 0.3 |
| Concurrent nerve injury | 29 (0.0%) | 100 (0.2%) | <.001 | 0.05 | 41 (0.1%) | 390 (1.1%) | <.001 | 0.14 |
| Concurrent tendon injury | 117 (0.2%) | 102 (0.3%) | .002 | 0.02 | 267 (0.4%) | 791 (2.2%) | <.001 | 0.17 |
| Admitted as inpatient for treatment | 1183 (1.7%) | 2810 (7.0%) | <.001 | 0.26 | 839 (1.1%) | 3040 (8.6%) | <.001 | 0.35 |
| Season of occurrence | ||||||||
| Q1: January-March | 18,170 (25.9%) | 11,677 (29.0%) | <.001 | 0.07 | 16,967 (22.7%) | 8245 (23.4%) | .001 | 0.02 |
| Q2: April-Jun | 16,599 (23.7%) | 9123 (22.6%) | 0.02 | 18,686 (25.0%) | 8781 (24.9%) | 0 | ||
| Q3: July-Sept | 18,352 (26.2%) | 9942 (24.7%) | 0.03 | 21,361 (28.6%) | 10,178 (28.9%) | 0.01 | ||
| Q4: Oct-Dec | 16,990 (24.2%) | 9560 (23.7%) | 0.01 | 17,772 (23.8%) | 8037 (22.8%) | 0.02 | ||
| Social Indicators | ||||||||
| Rurality, N (%) | ||||||||
| Missing | 1064 (1.5%) | 455 (1.1%) | <.001 | 0.03 | 1274 (1.7%) | 515 (1.5%) | .003 | 0.02 |
| Urban | 57,771 (82.4%) | 33,446 (83.0%) | 0.02 | 60,997 (81.6%) | 28,669 (81.4%) | 0.01 | ||
| Rural | 11,276 (16.1%) | 6401 (15.9%) | 0.01 | 12,515 (16.7%) | 6057 (17.2%) | 0.01 | ||
| Neighborhood Income, N (%) | ||||||||
| Quintile 1 (lowest income) | 13,952 (19.9%) | 7634 (18.9%) | .003 | 0.02 | 15,379 (20.6%) | 6928 (19.7%) | .004 | 0.02 |
| Quintile 2 | 13,954 (19.9%) | 7979 (19.8%) | 0 | 14,863 (19.9%) | 7145 (20.3%) | 0.01 | ||
| Quintile 3 | 13,659 (19.5%) | 8013 (19.9%) | 0.01 | 14,927 (20.0%) | 6951 (19.7%) | 0.01 | ||
| Quintile 4 | 13,632 (19.4%) | 7972 (19.8%) | 0.01 | 14,654 (19.6%) | 7067 (20.1%) | 0.01 | ||
| Quintile 5 (highest income) | 14,776 (21.1%) | 8635 (21.4%) | 0.01 | 14,766 (19.7%) | 7069 (20.1%) | 0.01 | ||
| Missing | 138 (0.2%) | 69 (0.2%) | 0.01 | 197 (0.3%) | 81 (0.2%) | 0.01 | ||
| Ontario Marginalization Index, N (%) | ||||||||
| Dependency | ||||||||
| Quintile 1 (lowest dependency) | 13,902 (19.8%) | 7598 (18.9%) | <.001 | 0.02 | 17,548 (23.5%) | 7972 (22.6%) | <.001 | 0.02 |
| Quintile 2 | 13,174 (18.8%) | 7298 (18.1%) | 0.02 | 15,152 (20.3%) | 7127 (20.2%) | 0 | ||
| Quintile 3 | 12,575 (17.9%) | 7257 (18.0%) | 0 | 13,933 (18.6%) | 6716 (19.1%) | 0.01 | ||
| Quintile 4 | 13,098 (18.7%) | 7694 (19.1%) | 0.01 | 13,474 (18.0%) | 6482 (18.4%) | 0.01 | ||
| Quintile 5 (highest dependency) | 16,708 (23.8%) | 10,201 (25.3%) | 0.03 | 13,888 (18.6%) | 6685 (19.0%) | 0.01 | ||
| Material Deprivation | ||||||||
| Quintile 1 (lowest deprivation) | 14,949 (21.3%) | 8623 (21.4%) | <.001 | 0 | 15,086 (20.2%) | 7135 (20.2%) | <.001 | 0 |
| Quintile 2 | 14,349 (20.5%) | 8343 (20.7%) | 0.01 | 15,033 (20.1%) | 7065 (20.0%) | 0 | ||
| Quintile 3 | 13,608 (19.4%) | 7985 (19.8%) | 0.01 | 14,414 (19.3%) | 6966 (19.8%) | 0.01 | ||
| Quintile 4 | 13,374 (19.1%) | 7595 (18.8%) | 0.01 | 14,361 (19.2%) | 6691 (19.0%) | 0.01 | ||
| Quintile 5 (highest deprivation) | 13,177 (18.8%) | 7502 (18.6%) | 0 | 15,101 (20.2%) | 7125 (20.2%) | 0 | ||
| Ethnic Concentration | ||||||||
| Quintile 1 (lowest concentration) | 13,661 (19.5%) | 8207 (20.4%) | <.001 | 0.02 | 14,157 (18.9%) | 7021 (19.9%) | <.001 | 0.03 |
| Quintile 2 | 13,545 (19.3%) | 8391 (20.8%) | 0.04 | 13,955 (18.7%) | 7127 (20.2%) | 0.04 | ||
| Quintile 3 | 13,572 (19.4%) | 8390 (20.8%) | 0.04 | 14,188 (19.0%) | 6974 (19.8%) | 0.02 | ||
| Quintile 4 | 14,184 (20.2%) | 8038 (19.9%) | 0.01 | 15,335 (20.5%) | 7027 (19.9%) | 0.01 | ||
| Quintile 5 (highest concentration) | 14,495 (20.7%) | 7022 (17.4%) | 0.08 | 16,360 (21.9%) | 6833 (19.4%) | 0.06 | ||
| Neighborhood Instability | ||||||||
| Quintile 1 | 12,093 (17.2%) | 6611 (16.4%) | <.001 | 0.02 | 14,290 (19.1%) | 6631 (18.8%) | <.001 | 0.01 |
| Quintile 2 | 12,916 (18.4%) | 7550 (18.7%) | 0.01 | 13,827 (18.5%) | 6795 (19.3%) | 0.02 | ||
| Quintile 3 | 13,015 (18.6%) | 7865 (19.5%) | 0.02 | 14,035 (18.8%) | 6847 (19.4%) | 0.02 | ||
| Quintile 4 | 13,753 (19.6%) | 8113 (20.1%) | 0.01 | 14,476 (19.4%) | 6893 (19.6%) | 0.01 | ||
| Quintile 5 | 17,680 (25.2%) | 9909 (24.6%) | 0.01 | 17,367 (23.2%) | 7816 (22.2%) | 0.02 | ||
| Missing | 654 (0.9%) | 254 (0.6%) | 0.03 | 791 (1.1%) | 259 (0.7%) | 0.03 | ||
| Comorbidities and health status, N (%) | ||||||||
| Rheumatoid Arthritis | 1414 (2.0%) | 987 (2.4%) | <.001 | 0.03 | 391 (0.5%) | 236 (0.7%) | .003 | 0.02 |
| Diabetes | 9991 (14.3%) | 6760 (16.8%) | <.001 | 0.07 | 7672 (10.3%) | 4533 (12.9%) | <.001 | 0.08 |
| Osteoporosis | 464 (0.7%) | 292 (0.7%) | .224 | 0.01 | 46 (0.1%) | 39 (0.1%) | .006 | 0.02 |
| Osteoarthritis | 2044 (2.9%) | 1313 (3.3%) | .001 | 0.02 | 962 (1.3%) | 577 (1.6%) | <.001 | 0.03 |
| Charlson comorbidity index | ||||||||
| 0 | 65,627 (93.6%) | 37,219 (92.4%) | <.001 | 0.05 | 71,624 (95.8%) | 33,318 (94.5%) | <.001 | 0.06 |
| 1 | 2088 (3.0%) | 1485 (3.7%) | 0.04 | 1398 (1.9%) | 869 (2.5%) | 0.04 | ||
| 2 | 1323 (1.9%) | 889 (2.2%) | 0.02 | 895 (1.2%) | 516 (1.5%) | 0.02 | ||
| 3+ | 1073 (1.5%) | 709 (1.8%) | 0.02 | 869 (1.2%) | 538 (1.5%) | 0.03 | ||