| Title |
Comparative Analysis of Length of Stay and Inpatient Costs for Orthopedic Surgery Patients Treated with IV Acetaminophen and IV Opioids vs. IV Opioids Alone for Post-Operative Pain
|
|---|---|
| Published in |
Advances in Therapy, July 2016
|
| DOI | 10.1007/s12325-016-0368-8 |
| Pubmed ID | |
| Authors |
Ryan N. Hansen, An Pham, Scott A. Strassels, Stela Balaban, George J. Wan |
| Abstract |
Recovery from orthopedic surgery is oriented towards restoring functional health outcomes while reducing hospital length of stay (LOS) and medical expenditures. Optimal pain management is a key to reaching these objectives. We sought to compare orthopedic surgery patients who received combination intravenous (IV) acetaminophen and IV opioid analgesia to those who received IV opioids alone and compared the two groups on LOS and hospitalization costs. We performed a retrospective analysis of the Premier Database (Premier, Inc.; between January 2009 and June 2015) comparing orthopedic surgery patients who received post-operative pain management with combination IV acetaminophen and IV opioids to those who received only IV opioids starting on the day of surgery and continuing up to the second post-operative day. The quarterly rate of IV acetaminophen use for all hospitalizations by hospital served as the instrumental variable in two-stage least squares regressions controlling for patient and hospital covariates to compare the LOS and hospitalization costs of IV acetaminophen recipients to opioid monotherapy patients. We identified 4,85,895 orthopedic surgery patients with 1,74,805 (36%) who had received IV acetaminophen. Study subjects averaged 64 years of age and were predominantly non-Hispanic Caucasians (78%) and female (58%). The mean unadjusted LOS for IV acetaminophen patients was 3.2 days [standard deviation (SD) 2.6] compared to 3.9 days (SD 3.9) with only IV opioids (P < 0.0001). Average unadjusted hospitalization costs were $19,024.9 (SD $13,113.7) for IV acetaminophen patients and $19,927.6 (SD $19,578.8) for IV opioid patients (P < 0.0001). These differences remained statistically significant in our instrumental variable models, with IV acetaminophen associated with 0.51 days shorter hospitalization [95% confidence interval (CI) -0.58 to -0.44, P < 0.0001] and $634.8 lower hospitalization costs (95% CI -$1032.5 to -$237.1, P = 0.0018). Compared to opioids alone, managing post-orthopedic surgery pain with the addition of IV acetaminophen is associated with shorter LOS and decreased hospitalization costs. Mallinckrodt Pharmaceuticals. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 50% |
| Science communicators (journalists, bloggers, editors) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 2% |
| Unknown | 46 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Doctoral Student | 11 | 23% |
| Researcher | 9 | 19% |
| Student > Bachelor | 3 | 6% |
| Other | 3 | 6% |
| Student > Master | 3 | 6% |
| Other | 8 | 17% |
| Unknown | 10 | 21% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 17 | 36% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 11% |
| Nursing and Health Professions | 4 | 9% |
| Agricultural and Biological Sciences | 2 | 4% |
| Psychology | 2 | 4% |
| Other | 3 | 6% |
| Unknown | 14 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 March 2021.
All research outputs
#2,348,178
of 22,880,691 outputs
Outputs from Advances in Therapy
#185
of 2,353 outputs
Outputs of similar age
#44,872
of 356,439 outputs
Outputs of similar age from Advances in Therapy
#6
of 52 outputs
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So far Altmetric has tracked 2,353 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.3. This one has done particularly well, scoring higher than 92% of its peers.
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We're also able to compare this research output to 52 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.