Association between preoperative self-rated health and opioid use 12 months after total hip arthroplasty for osteoarthritis: a cohort study using Danish National Health Survey Data
DOI:
https://doi.org/10.2340/17453674.2025.44758Keywords:
Arthroplasty, Hip, Opioids, Self-rated healthAbstract
Background and purpose: We examined the association between preoperative self-rated health (SRH) and opioid use 12 months after total hip arthroplasty (THA) for osteoarthritis.
Methods: We identified 381,323 people who answered a question on SRH in the Danish National Health Surveys 2010, 2013, or 2017. Among these, 4,174 people age > 35 years subsequently underwent THA for osteoarthritis. SRH was categorized as poor (“poor” or “fair” health) or good (“good,” “very good,” or “excellent” health). Opioid use was defined as ≥ 2 prescriptions 1–12 months after THA. We calculated prevalences and prevalence ratios (PR) with 95% confidence intervals (CI) through log-binomial regression, overall and by preoperative opioid use status adjusting for potential confounders. The total morphine milligram equivalent (MME) dose after THA with interquartile range (IQR) was further calculated.
Results: 876 (21%) patients rated their health as poor and 3,292 (79%) as good. The prevalence of opioid use among patients with poor SRH was higher than among those with good SRH (PR 2.33, CI 2.05–2.65) (315 [36%] vs 132 [14%]). Similarly, among preoperative non-users, the prevalence was 62 (15%) for patients with poor SRH and 140 (6%) for patients with good SRH (PR 2.20, CI 1.65–2.93), and among preoperative users, the prevalence was 252 (54%) for patients with poor SRH and 299 (31%) for patients with good SRH (PR 1.64, CI 1.44–1.86). The overall median MME dose was higher among patients with poor SRH (2,940, IQR 800–9,610) than among those with good SRH (1,000, IQR 400–3,175) with a median difference of 1,940 (IQR 1,227–2,653).
Conclusion: Compared with good preoperative SRH, poor preoperative SRH was associated with higher opioid use 12 months after THA for osteoarthritis.
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Copyright (c) 2025 Alma B Pedersen, Nina M Edwards, Maaike G J Gademan, Inger Mechlenburg, Heidi A R Jensen, Henrik T Sørensen
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