Patient-Reported Data Augment Prediction Models of Persistent Opioid Use after Elective Upper Extremity Surgery.

Background: Opioids play a role in pain management after surgery, but prolonged use contributes to developing opioid use disorder. Identifying patients at risk of prolonged use is critical for deploying interventions that reduce or avoid opioids; however, available predictive models do not incorporate patient-reported data (PRD), and it remains unclear whether PRD can predict postoperative use behavior. The authors used a machine learning approach leveraging preoperative PRD and electronic health record data to predict persistent opioid use after upper extremity surgery.

Preoperative Patient-Reported Data Indicate the Risk of Prolonged Opioid Use After Hand and Upper Extremity Surgeries.

Purpose: Opioids play an important role in pain management after surgery but also increase the risk of prolonged opioid use in patients. The identification of patients who are more likely to use opioids after intended short-term treatment is critical for employing alternative management approaches or targeted interventions for the prevention of opioid-related problems. We used patient-reported data (PRD) and electronic health record information to identify factors predictive of prolonged opioid use after surgery.

Trends in upper extremity injuries presenting to emergency departments during the COVID-19 pandemic.

Introduction: During the emergence of the SARS-CoV-2 (COVID-19) pandemic, there were substantial changes in United States (U.S.) emergency department (ED) volumes and acuity of patient presentation compared to more recent years.

The Curtis Hand Injury Matrix Score: Determining the Need for Specialized Upper Extremity Care.

Purpose: Given the limited impact of transfer guidelines and the lack of comparative metrics for upper extremity trauma, we introduced the Curtis Hand Injury Matrix (CHIM) score to evaluate upper extremity injury acuity from the specialist perspective. Our goal was to evaluate the CHIM score as an indicator of complexity and specialist need by correlating the score with arrival mode, length of stay (LOS), discharge disposition, and procedure location.

Methods: We identified all hand and upper extremity emergency room visits at our institution in 2018 and 2019.

Disparities Limit the Effect and Benefit of a Web-Based Clinic Intake System.

With increasing value being placed on patient-centered care and the focus on efficiency and workflow in health care delivery, the authors have implemented a web-based system for demographic, medical history, and patient-reported outcomes data collection for every clinical visit at their specialty upper-extremity center. They evaluated initial success and disparities in use after 12 months. The authors evaluated questionnaire parameters from 2018 patients, focusing primarily on the new patient intake form.

Variation in Postoperative Opioid Prescribing Among Upper-Extremity Surgery Providers.

Purpose: To identify targets for corrective interventions and guide improved opioid stewardship, we studied opioid prescribing patterns of attending surgeons compared with surgical trainees for 2 upper-extremity surgeries: open reduction internal fixation (ORIF) of distal radius fractures (DRF), and carpal tunnel release (CTR).

Methods: We retrospectively reviewed records for all patients who underwent CTR or DRF ORIF at 6 hospitals across a large health system from 2016 to 2018. We collected prescriber training level (attending vs trainee), analgesic prescribed, and amount initially prescribed after surgery converted to oral morphine equivalents (OMEs).