Patient characteristics in the two cohorts
| No persistent opioid use | Persistent opioid use | P value | |||
| N | % | N | % | ||
| Total | 800 | 242 | |||
| Surgical procedure | <0.0001 | ||||
| Hip arthroplasty, posterolateral approach | 224 | 28.0 | 26 | 10.7 | |
| Hip arthroplasty, anterior approach | 161 | 20.1 | 55 | 22.7 | |
| Revision hip arthroplasty | 42 | 5.3 | 18 | 7.4 | |
| Total knee arthroplasty | 315 | 39.4 | 111 | 45.9 | |
| Revision knee arthroplasty | 58 | 7.3 | 32 | 13.2 | |
| Age (years), mean (SD) | 68.7(10.5) | 64.9(11.2) | <0.0001 | ||
| Male sex | 271 | 33.9 | 77 | 31.8 | 0.61 |
| Body mass index (kg/m2), mean (SD) | 29.1 (5.0) | 30.1 (5.6) | 0.01 | ||
| English-speaking | 746 | 93.3 | 220 | 90.9 | 0.28 |
| Preoperative opioid use | 83 | 10.4 | 111 | 45.9 | <0.0001 |
| Previous joint replacement surgery | 330 | 41.3 | 114 | 47.1 | 0.12 |
| Comorbidities | |||||
| Hypertension | 473 | 59.1 | 145 | 59.9 | 0.88 |
| Coronary artery disease | 75 | 9.4 | 34 | 14.0 | 0.05 |
| Congestive heart failure | 20 | 2.5 | 19 | 7.9 | 0.0003 |
| Chronic obstructive pulmonary disease | 40 | 5.0 | 28 | 11.6 | 0.0005 |
| No persistent opioid use | Persistent opioid use | ||||
| Comorbidities continued | n | % | n | % | P value |
| Asthma | 77 | 9.6 | 23 | 9.5 | 0.99 |
| Obstructive sleep apnea | 132 | 16.5 | 54 | 22.3 | 0.05 |
| Diabetes mellitus | 119 | 14.9 | 50 | 20.7 | 0.04 |
| Insulin-dependent diabetes mellitus | 26 | 3.3 | 13 | 5.4 | 0.18 |
| Anxiety/depression | 208 | 26.0 | 92 | 38.0 | 0.0004 |
| Dementia | 2 | 0.3 | 0 | 0.0 | 0.99 |
| Renal insufficiency | 60 | 7.5 | 13 | 5.4 | 0.32 |
| Frequent alcohol use (≥1 drink per day) | 387 | 48.4 | 122 | 50.4 | 0.63 |
| Active smoker | 222 | 27.8 | 74 | 30.6 | 0.13 |
| Frequent marijuana use (≥once/week) | 25 | 3.1 | 23 | 9.5 | <0.0001 |
| Active illicit drug use | 9 | 1.1 | 12 | 5.0 | 0.0005 |
| Severe osteoarthritis of the surgical joint | 486 | 60.8 | 122 | 50.4 | 0.005 |
| Fracture | 8 | 1.0 | 18 | 7.4 | <0.0001 |
| Intraoperative | |||||
| Primary anesthetic: neuraxial | 460 | 57.5 | 133 | 55.0 | 0.53 |
| Peripheral nerve block performed | 349 | 43.6 | 133 | 55.0 | 0.002 |
| Intraoperative dexmedetomidine | 181 | 22.6 | 52 | 21.5 | 0.78 |
| Intraoperative ketamine | 48 | 6.0 | 32 | 13.2 | 0.0004 |
| Postoperative | |||||
| POD 1 opioid consumption (MEQ) | 13.2(20.3) | 24.7 (22.6) | <0.0001 | ||
| Hospital length of stay (days), mean (SD) | 2.3 (1.6) | 3.3 (2.4) | <0.0001 | ||
| Discharge medications | |||||
| Total opioids prescribed at discharge (MEQ) | 235.4 (176.5) | 234.2 (172.1) | 0.92 | ||
| Oxycodone prescribed | 685 | 85.6 | 195 | 80.6 | 0.07 |
| Morphine prescribed | 45 | 5.6 | 42 | 17.4 | <0.0001 |
| Hydromorphone prescribed | 14 | 1.8 | 12 | 5.0 | 0.01 |
| Tramadol prescribed | 124 | 15.5 | 30 | 12.4 | 0.28 |
| Hydrocodone prescribed | 22 | 2.8 | 0 | 0.0 | 0.02 |
χ2 test was used to compare categorical variables.
Student’s t-test was used to compare continuous variables.
MEQ, intravenous morphine equivalent; POD, postoperative day.