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\title{Prevalence and predictors of opioid use before orthopaedic surgery in an
Australian setting: a multicentre, cross-sectional, observational study}



\author[1]{Shania Liu}%
\author[2]{Jennifer Stevens}%
\author[2]{Ashleigh Collins}%
\author[3]{Jedd Duff}%
\author[4]{Joanna Sutherland}%
\author[5]{Morgan Oddie}%
\author[6]{Justine  Naylor}%
\author[7]{Asad Patanwala}%
\author[8]{Benita Suckling}%
\author[9]{Jonathan Penm}%
\affil[1]{Affiliation not available}%
\affil[2]{The University of Notre Dame Australia}%
\affil[3]{Queensland University of Technology}%
\affil[4]{University of New South Wales Rural Clinical School Mid North Coast Division Coffs Harbour Campus}%
\affil[5]{St George Public Hospital}%
\affil[6]{UNSW}%
\affil[7]{University of Sydney}%
\affil[8]{Royal Brisbane and Women's Hospital}%
\affil[9]{The University of Sydney}%


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  \date{May 26, 2024}


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\begin{abstract}
Aim: This study aimed to examine the prevalence of any opioid use before
elective orthopaedic surgery with a focus on regional and rural
hospitals in New South Wales, Australia. Methods: This was a
cross-sectional, observational study of patients undergoing orthopaedic
surgery conducted between April 2017 and November 2019 across five
hospitals that included a mix of capital city, regional, rural, private
and public settings. Preoperative patient demographics, pain scores and
analgesic use were collected during pre-admission clinic visits, held on
average two to six weeks before surgery. Results: Of the 430 patients
included (53.3\% (229/430) women; mean age, 67.5 {[}standard deviation
{[}SD{]} 10.1{]} years), the overall prevalence of any preoperative
opioid use was 37.7\% (162/430). Rates of preoperative opioid use ranged
from 20.6\% (13/63) at a capital city metropolitan hospital to 48.8\%
(21/43) at a regional metropolitan hospital. Multivariable logistic
regression showed that the regional metropolitan setting was a
significant predictor of opioid use before orthopaedic surgery (adjusted
odds ratio {[}aOR{]}, 2.6; 95\% confidence interval {[}CI{]}, 1.0 --
6.7) after adjusting for covariates. Conclusion: Opioid use prior to
orthopaedic surgery is common and appears to vary by geographic
location. Given its use is associated with worse postoperative outcomes,
rigorous efficacy studies involving different geographic locations are
required to determine whether opioid tapering prior to surgery can
reduce harm.%
\end{abstract}%



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