Opioid intake prior to admission is not increased in elderly patients with low‐energy fractures: A case–control study in a German hospital population. (4th June 2018)

• Record Type: Journal Article
• Authors: Schwarzer, A.; Kaisler, M.; Kipping, K.; Seybold, D.; Rausch, V.; Maier, C.; Vollert, J.
• Is Part Of: European journal of pain. Volume 22:Number 9(2018)
• Page Start: 1651
• Page End: 1661
• Publication Date: 2018-06-04
• Subjects: Pain -- Periodicals; Pain -- Treatment -- Periodicals; Pain -- Physiological aspects -- Periodicals; 616.0472
• DOI: 10.1002/ejp.1247
• Languages: English
• ISSNs: 1090-3801

Abstract

Abstract: Background: Recent studies revealed an increased prescription rate of opioids for elderly patients suffering bone fractures. To gain further insight, we conducted face‐to‐face interviews in the present study to compare the opioid intake between patients with low‐energy fractures and patients suffering from internal diseases. Methods: In this case–control study, 992 patients, aged 60 years and older, were enrolled between March 2014 and February 2015. The interview comprised a fall and medication history, comorbidities, mobility and other risk factors for fractures. Odds ratios (OR) and a multiple logistic regression model were calculated. Results: The number of patients with pre‐admission opioid intake in the last 12 months was comparable in the fracture ( n = 399, 13.3%) and the control group ( n = 593, 14.7% OR: 0.89, CI: 0.62–1.29). The number of patients with current opioid intake of short duration (<3 months) was similar in both groups (14% vs. 20%; OR: 0.66, CI: 0.23–1.93). Patients with opioid intake in the fracture group reported more frequently fatigue as an adverse event of opioid medication (58% vs. 30%; OR: 3.32, CI: 1.48–7.45). Patients with opioid intake showed more severe comorbidities and significantly decreased mobility compared to those without opioids. Conclusion: Elderly patients internalized due to low‐energy fractures did not take opioids more frequently than patients with internal admission, for both short (<3 months) and longer duration intake. Patients with opioid intake were generally in poorer physical condition. The risk of fracture might increase in patients suffering from fatigue as a side effect of opioid medication. Significance: This study is based on face‐to‐face interviews with patients, including details about side effects and fracture history, providing a more pronounced picture of the relation of opioid intake and risk of fracture.