1062 Opioid Requirements During Rehabilitation After Pelvic Fracture

Abstract

Abstract Aim Pelvic fractures are highly traumatic and debilitating injuries for patients, with an arduous rehabilitation process. Our study analyses the predictors for opioid requirements in pelvic fractures. Method Data was collected from all pelvic fractures treated at a Major Trauma Centre from 2015-2021, including fracture location, demographics, and comorbidities. Opioid prescriptions in the first post-injury year were calculated every month up to 6 months, and then from the 7th-12th month period. We calculated the total strength in Morphine Milligram Equivalents (MME), and days with at least one opioid prescribed (“coverage”). Multivariate regression was performed on the outcomes. Results A total of 3137 patients with pelvic fractures were included, with mean 954 MME (95%, CI = 899-999) in the first year. Acetabulum fractures showed lower strength in the 1st, and 7–12-month periods, with lower coverage in the 1st- 3rd months (p<0.05). Pubis fractures needed higher strength opioids for more days across all time intervals (p<0.01). On multivariate comorbidity analysis, in every subinterval after 1st month and overall, higher BMI and age, pulmonary disease, and drug abuse were associated with higher strength. In every subinterval after 4th month and overall, liver disease was associated with higher strength (p<0.05). Higher age and BMI were associated with increased coverage overall and every individual month (p<0.01), with chronic kidney disease and rheumatological conditions associated with increased coverage after the 2nd month (p<0.05). Conclusions Our study highlights the various injury, demographic and comorbidity factors that predispose patients to requiring higher strength and coverage of opioids during their rehabilitation from pelvic fractures.