Opioid use for a first-incident upper extremity fracture in 220,440 patients without recent prior use in Ontario, Canada: A retrospective cohort study

Abstract

Objective: To describe opioid use for a first upper extremity fracture in a cohort of patients who did not have recent opioid use. Design: Descriptive epidemiological study. Setting: Emergency Department, Hospital. Patients/Participants: We obtained health administrative data records of adults presenting with a first adult upper extremity fracture from 2013 to 2017 in Ontario, Canada. We excluded patients with previous fractures, opioid prescription in the past 6 months or hospitalization >5 days after the fracture. Intervention: Opioid prescription. Main Outcome Measurements: We identified the proportion of patients filling an opioid prescription within 7 days of fracture. We described this based on different upper extremity fractures (ICD-10), Demographics (age, sex, rurality), comorbidity (Charlson Comorbidity Index, Rheumatoid arthritis, Diabetes), season of injury, and social marginalization (Ontario Marginalization Index-a data algorithm that combines a wide range of demographic indicators into 4 distinct dimensions of marginalization). We considered statistical differences (P