PMID- 36732305
OWN - NLM
STAT- MEDLINE
DCOM- 20230206
LR  - 20230830
IS  - 2474-7661 (Electronic)
IS  - 2474-7661 (Linking)
VI  - 6
IP  - 12
DP  - 2022 Dec 1
TI  - Admission NarxCare Narcotic Scores Are Associated With Increased Odds of 
      Readmission and Prolonged Length of Hospital Stay After Primary Elective Total 
      Knee Arthroplasty.
LID - 10.5435/JAAOSGlobal-D-22-00040 [doi]
LID - e22.00040
AB  - INTRODUCTION: The association of preoperative narcotic use with postoperative 
      outcomes after primary elective total knee arthroplasty (TKA) has remained poorly 
      characterized. The NarxCare platform analyzes patients' state Prescription Drug 
      Monitoring Program records to assign numerical scores that approximate a 
      patient's overall opioid usage. The present study investigated the utility of 
      admission NarxCare narcotic scores in predicting the odds of adverse events (AEs) 
      after primary elective TKA. METHODS: Elective primary TKA patients performed at a 
      single institution between October 2017 and May 2020 were evaluated. NarxCare 
      narcotic scores at the time of admission, patient characteristics, 30-day AEs, 
      readmissions, revision surgeries, and mortality were abstracted. Elective TKA 
      patients were binned based on admission NarxCare narcotic scores. The odds of 
      experiencing adverse outcomes were compared. RESULTS: In total, 1136 patients met 
      the criteria for inclusion in the study (Narx Score 0: n = 293 [25.8%], 1 to 99: 
      n = 253 [22.3%], 100 to 299: n = 368 [32.4%], 300 to 499: n = 161 [14.2%], and 
      500+: n = 61 [5.37%]). By logistic regression, patients with higher admission 
      narcotic scores tended to have a dose-dependent increase in the odds of prolonged 
      length of hospital stay, readmission within 30 days, and aggregated AEs. 
      DISCUSSION: Admission narcotic scores may be used to predict readmission and to 
      stratify TKA patients by risk of AEs.
CI  - Copyright (c) 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf 
      of the American Academy of Orthopaedic Surgeons.
FAU - Galivanche, Anoop R
AU  - Galivanche AR
AUID- ORCID: 0000-0003-3362-1930
AD  - From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 
      New Haven, CT.
FAU - Zhu, Justin
AU  - Zhu J
AUID- ORCID: 0000-0001-9422-2867
FAU - Mercier, Michael R
AU  - Mercier MR
FAU - McLean, Ryan
AU  - McLean R
AUID- ORCID: 0000-0003-1402-1745
FAU - Wilhelm, Christopher V
AU  - Wilhelm CV
FAU - Varthi, Arya G
AU  - Varthi AG
FAU - Grauer, Jonathan N
AU  - Grauer JN
AUID- ORCID: 0000-0002-2626-7278
FAU - Rubin, Lee E
AU  - Rubin LE
AUID- ORCID: 0000-0002-7259-6355
LA  - eng
GR  - T35 AA023760/AA/NIAAA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221205
PL  - United States
TA  - J Am Acad Orthop Surg Glob Res Rev
JT  - Journal of the American Academy of Orthopaedic Surgeons. Global research & 
      reviews
JID - 101724868
RN  - 0 (Narcotics)
SB  - IM
MH  - Humans
MH  - Length of Stay
MH  - *Narcotics/adverse effects
MH  - *Arthroplasty, Replacement, Knee/adverse effects
MH  - Patient Readmission
MH  - Hospitalization
PMC - PMC9726283
COIS- The following disclosures have been collected and reported per International 
      Committee of Medical Journal Editors (ICMJE) reporting standards. Dr. Grauer or 
      an immediate family member reports personal fees from TIDI Products and the North 
      American Spine Society, outside the submitted work. Dr. Rubin or an immediate 
      family member reports personal fees from DePuy Synthes, ConvaTec, Thompson 
      Surgical Instruments, SLACK Publishers, and Johns Hopkins University Press and 
      other from 3D Surgical, Inc, outside the submitted work. None of the 
      aforementioned disclosures pose relevant conflicts of interest to the current 
      study. None of the following authors or any immediate family member has received 
      anything of value from or has stock or stock options held in a commercial company 
      or institution related directly or indirectly to the subject of this article.
EDAT- 2023/02/03 06:00
MHDA- 2023/02/07 06:00
PMCR- 2022/12/05
CRDT- 2023/02/02 22:42
PHST- 2022/02/01 00:00 [received]
PHST- 2022/02/07 00:00 [accepted]
PHST- 2023/02/02 22:42 [entrez]
PHST- 2023/02/03 06:00 [pubmed]
PHST- 2023/02/07 06:00 [medline]
PHST- 2022/12/05 00:00 [pmc-release]
AID - 01979360-202212000-00002 [pii]
AID - JAAOSGLOBAL-D-22-00040 [pii]
AID - 10.5435/JAAOSGlobal-D-22-00040 [doi]
PST - epublish
SO  - J Am Acad Orthop Surg Glob Res Rev. 2022 Dec 5;6(12):e22.00040. doi: 
      10.5435/JAAOSGlobal-D-22-00040. eCollection 2022 Dec 1.