Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Pain Treatments After Hip Fracture Among Older Nursing Home Residents.

Zullo AR, Zhang T, Beaudoin FL, Lee Y, McConeghy KW, Kiel DP, Daiello LA, Mor V, Berry SD. Pain Treatments After Hip Fracture Among Older Nursing Home Residents. Journal of The American Medical Directors Association. 2018 Feb 1; 19(2):174-176.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions



Abstract:

OBJECTIVES: To examine the association between use of opioids versus other analgesics with death and functioning after hip fracture in older nursing home (NH) residents. DESIGN: Retrospective cohort using national Medicare fee-for-service claims linked to the Minimum Data Set. SETTING: US NHs. PARTICIPANTS: NH residents aged = 65 years who became a long-stay resident ( > 100 days in the NH) between January 2008 and December 2009, had a hospitalized hip fracture, and returned to the NH. EXPOSURE: New use of opioid versus nonopioid analgesics (acetaminophen or nonsteroidal anti-inflammatory drugs) within 14 days post hip fracture. MEASUREMENTS: Follow-up began on the index date and continued until the first occurrence of death, significant functional decline (3-point increase on MDS Activities of Daily Living scale), or 120 days of follow-up. Odds ratios (ORs) with 95% confidence intervals (CIs) for outcomes were estimated using inverse probability of treatment-weighted multinomial logistic regression models. RESULTS: Among the 2755 NH residents with a hip fracture included in our study, 1155 (41.9%) were opioid users, and 1600 (58.1%) were nonopioid analgesic users. The mean age was 86.3 years, 73.8% were female, and 86.0% were white. Opioid use was associated with a significantly lower likelihood of death (OR  = 0.47, 95% CI 0.39-0.56) and a nonsignificant decrease in functional decline (OR  = 0.77, 95% CI 0.58-1.03). CONCLUSION: A rigorous study that addresses the limitations of this study is critical to validate our preliminary findings and provide evidence about the effect of using opioid versus nonopioid analgesics to optimize acute pain in NH residents with a hip fracture.





Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.