Table 2.
Analysis of Long-Term Opioid Use ≥6 Months (Group A) versus Moderate and Short-Term Use (Group B+C)
| Model A Socioeconomicsa HR, Mutually Adjusted | Model B Socioeconomics, Sex, and Ageb HR, Mutually Adjusted | Model C Socioeconomics, Sex, Age, and Major Comorbid Conditionsc HR, Mutually Adjusted | |
|---|---|---|---|
| Education | |||
| Primary school (ref) | 1 | 1 | 1 |
| Secondary school | 0.85 (0.81–0.89)*** | 0.86 (0.81–0.90)*** | 0.92 (0.87–0.97)** |
| Bachelor’s degree or higher | 0.73 (0.68–0.79)*** | 0.72 (0.67–0.78)*** | 0.80 (0.74–0.86)*** |
| Unknown | 1.10 (1.00–1.21)* | 1.12 (1.02–1.23)* | 1.07 (0.97–1.18) |
| Living conditions | |||
| Children at home (<25 years), yes | 0.92 (0.87–0.97)** | 0.86 (0.0.80–0.91)*** | 0.86 (0.82–0.92)*** |
| Marital status | |||
| Married | 1 | 1 | 1 |
| Widowed | 0.98 (0.90–1.06) | 0.95 (0.87–1.03) | 0.93 (0.86–1.01) |
| Divorced | 1.13 (1.06–1.21)*** | 1.10 (1.03–1.18)** | 1.07 (1.00–1.15)* |
| Single (unmarried) | 0.95 (0.90–1.01) | 0.95 (0.88–1.02) | 0.95 (0.89–1.02) |
| Unknown marital status | 0.11 (0.02–0.68)* | 0.11 (0.02–0.72)** | 0.11 (0.02–0.71)* |
| Living area/Municipality | |||
| Capital area 1,500,000 | 0.65 (0.47–0.89)** | 0.64 (0.47–0.88)** | 0.74 (0.53–1.02) |
| Larger city ≥100,000 <1,500,000 | 0.86 (0.62–1.19) | 0.85 (0.62–1.18) | 0.79 (0.57–1.09) |
| City 20,000–99,999 | 0.87 (0.64–1.20) | 0.87 (0.63–1.19) | 0.85 (0.61–1.16) |
| Small city 1000–19,999 | 0.82 (0.60–1.12) | 0.81 (0.59–1.12) | 0.80 (0.59–1.11) |
| Countryside or a village ≤999 | 0.85 (0.62–1.17) | 0.86 (0.62–1.17) | 0.88 (0.60–1.14) |
| Household income | |||
| Lowest sextile (≤150.000 Dkr) | 1.02 (0.88–1.19) | 1.02 (0.87–1.18) | 1.04 (0.89–1.22) |
| Lowest tertile (≤199.999 Dkr) (ref) | 1 | 1 | 1 |
| Middle tertile (≥200,000 but ≤400,000 Dkr) | 0.88 (0.82–0.94)*** | 0.88 (0.81–0.94)*** | 0.92 (0.85–0.98)* |
| Highest tertile (>400,000 Dkr) | 0.80 (0.75–0.86)*** | 0.80 (0.7–086)*** | 0.88 (0.81–0.95)** |
| Unknown | 1.06 (0.78–1.42) | 1.03 (0.77–1.39) | 1.05 (0.78–1.42) |
| Opioid dose in mg OMEQ/day | |||
| Up to 1 month (50–80,640), Mean (552.37) (ref) | 1 | 1 | 1 |
| Up to 3 months (50–142,590), Mean (817.03) | 0.97 (0.97–0.97)*** | 0.97 (0.97–0.97)*** | 0.97 (0.97–0.97)*** |
| Up to 6 months (50–283,711), Mean (1114.26) | 0.87 (0.83–0.92)*** | 0.88 (0. 83–0.92)*** | 0.88 (0.83–0.93)*** |
| Up to 1 year (50–402,000), Mean (1583.30) | 1.18 (1.12–1.24)*** | 1.18 (1.12–1.24)*** | 1.18 (1.11–1.24)*** |
| Sex | |||
| Male | 0.83 (0.80–0.87)*** | 0.86 (0.82–0.90)*** | |
| Age at inclusion | |||
| 1st quartile (16–39 years) ref. | 1 | 1 | |
| 2nd quartile (40–53 years) | 1.12 (1.04–1.20)** | 1.11 (1.03–1.19)** | |
| 3rd quartile (54–68 years) | 0.96 (0.88–1.04) | 0.93 (0.85–1.02) | |
| 4th quartile (69–110 years) | 0.95 (0.87–1.04) | 0.84 (0.75–0.95)** | |
| Employment/income source | |||
| Employed | 1.02 (0.90–1.16) | ||
| Retired | 1.46 (1.27–1.68)*** | ||
| Social welfare | 1.58 (1.37–1.82)*** | ||
| Unemployed ≥6 monthsa | 1.27 (1.05–1.53)* | ||
| Region of municipality | |||
| Capital | 0.79 (0.71–0.87)*** | ||
| Zealand | 0.88 (0.80–0.96)** | ||
| Southern Denmark | 0.95 (0.88–1.03) | ||
| Central Jutland | 0.96 (0.89–1.04) | ||
| Northern Jutland | 1.08 (1.01–1.16)* | ||
| Number of drugs (co-medication) | |||
| 0 (ref) | 1 | ||
| 1–3 | 0.94 (0.87–1.01) | ||
| 4–9 | 0.93 (0.84–1.03) | ||
| 10+ | 0.97 (0.82–1.15) | ||
| Type of co-medication | |||
| Anti-hypertension | 0.94 (0.75–1.18) | ||
| Anti-coagulation AC | 1.01 (0.93–1.10) | ||
| ACE inhibitor | 0.92 (0.85–1.01) | ||
| Ischemic heart disease | 0.66 (0.36–1.19) | ||
| Antiarrhythmics | 1.11 (0.98–1.27) | ||
| AT2 antagonists | 0.96 (0.87–1.06) | ||
| Beta-blockers | 1.08 (1.00–1.17)* | ||
| Anti-diabetics | 1.15 (1.1.00–1.32)* | ||
| Lipid-lowering | 0.80 (0.73–0.88)*** | ||
| Prednisolone | 1.01 (0.93–1.10) | ||
| Immunosuppressants | 0.79 (0.62–1.01) | ||
| Anti-rheumatics | 1.07 (1.01–1.13)* | ||
| Joint and muscular pain | 1.12 (0.98–1.29) | ||
| Anti-epileptics | 0.89 (0.78–1.02) | ||
| Parkinson medications | 0.99 (0.81–1.21) | ||
| Other antidepressants | 1.04 (0.92–1.17) | ||
| SSRI | 1.01 (0.89–1.15) | ||
| Charlson index (numbers of comorbidity) | |||
| 0 (ref) | 1 | ||
| 1 | 0.90 (0.81–0.99)* | ||
| 2 | 0.89 (0.78–1.03) | ||
| 3+ | 0.89 (0.73–1.08) | ||
| Comobidity | |||
| Diabetes | 1.01 (0.83–1.23) | ||
| Pulmonary disease | 1.00 (0.87–1.14) | ||
| Hemiplegia | 0.36 (0.06–2.15) | ||
| Dementia | 0.79 (0.53–1.18) | ||
| Heart failure | 0.91 (0.83–1.00)* | ||
| Fracture ≤90 days before index | |||
| Spine | 0.93 (0.72–1.19) | ||
| Hip | 0.92 (0.76–1.10) | ||
| Forearm | 0.97 (0.81–1.15) | ||
| Humerus | 1.00 (0.84–1.18) | ||
| Any fracture | 0.99 (0.91–1.07) | ||
| Surgery ≤90 days before index | |||
| Skull/intracranial | 0.62 (0.30–1.30) | ||
| Spinal cord/nerve root | 0.77 (0.52–1.16) | ||
| Peripheral nerves | 0.95 (0.53–1.72) | ||
| The autonomic nervous system | 0.45 (0.02–8.55) | ||
| Endocrine organs | 0.75 (0.14–4.05) | ||
| Ear, nose or larynx | 1.24 (0.72–2.13) | ||
| Lips, teeth, jaw, mouth or throat | 0.50 (0.32–0.76)** | ||
| Heart/large vessels in thorax | 0.72 (0.51–1.00)* | ||
| Peripheral vessels/lymphatic | 0.97 (0.68–1.39) | ||
| Resp. sys., thorax, mediastinum or diaphragma | 0.69 (0.47–1.03) | ||
| Digestive organs or spleen | 0.84 (0.69–1.02) | ||
| Urin, male genitalia | 1.07 (0.74–1.55) | ||
| Female genitalia | 0.83 (0.62–1.12) | ||
| Obstetric surgery | 0.60 (0.33–1.07) | ||
| Minorb | 1.12 (1.02–1.23)* | ||
| Back or neck | 1.08 (0.72–1.61) | ||
| Shoulder or upper arm | 0.84 (0.67–1.05) | ||
| Elbow or forearm | 0.67 (0.50–091)** | ||
| Wrist or hand | 0.90 (0.66–1.22) | ||
| Pelvis | 1.02 (0.57–185) | ||
| Hip or thigh | 0.77 (0.65–0.90)** | ||
| Knees, lower legs, ankle or foot | 0.87 (0.77–0.97)* |
Notes: aUnemployed ≥ 6 months: a category extracted from the other income categories. bMinor: eye, breast, skin, minor surgical procedures, endoscopies, procedures during surgery, tissue withdrawals for transplantation. cMajor comorbid conditions: diabetes, pulmonary disease, hemiplegia, dementia, heart failure. *p<0.05, **p<0.01, ***p<0.001.
Abbreviation: HR, hazard ratio.