April 27, 2018 | Today’s News

Study: Despite risks, patients prescribed benzodiazepines also likely to be prescribed opioids

A study published online in JAMA Psychiatry suggests that patients who are prescribed benzodiazepines may be more likely than the general population to also be prescribed opioids, despite an increased risk of overdose. The researchers reviewed data on 13,146 patient visits from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey from Jan. 1, 2005, through Dec. 31, 2015. They found that rates of new opioid prescriptions among adults using a benzodiazepine increased from 189 to 351 per 1,000 persons between 2005 and 2010, then decreased to 172 per 1,000 persons by 2015. Over the same period, new opioid prescriptions in the general population not using benzodiazepines increased nonsignificantly from 78 to 93 per 1,000 persons from 2005 to 2010 and decreased nonsignificantly to 79 per 1,000 persons by 2015. After adjustment for demographic characteristics, comorbidities, and diagnoses associated with pain, the researchers found that the likelihood of receiving a new opioid prescription during an ambulatory visit remained higher for patients concurrently using benzodiazepines compared with the general population.

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Study: Older surgeon age linked to lower operative mortality rates

According to a study published online in The BMJ, patients treated by older surgeons may be at decreased risk of mortality compared to those treated by younger surgeons. Members of the research team reviewed information on 892,187 patients treated by 45,826 surgeons and found that adjusted operative mortality rates were 6.6 percent for surgeons aged younger than 40 years, 6.5 for surgeons aged 40–49 years, 6.4 for surgeons aged 50–59 years, and 6.3 for surgeons aged 60 years or older. They found no evidence that adjusted operative mortality differed between patients treated by female versus male surgeons. Overall, female surgeons in their 50s had the lowest operative mortality.

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Data from a study published online in Clinical Orthopaedics and Related Research suggest no association between borderline-to-mild dysplasia and the pathogenesis of osteoarthritis (OA). The authors evaluated bilateral hips of patients with developmental dysplasia of the hip who underwent eccentric rotational acetabular osteotomy (ERAO; n = 46) for inclusion in the dysplasia group and contralateral hips of patients with unilateral idiopathic osteonecrosis of the femoral head (ONFH; n = 32) who underwent curved intertrochanteric varus osteotomy (CVO) for the control group. The study included 55 hips categorized according to dysplasia severity: borderline-mild, 19 hips; moderate, 20 hips; severe, 16 hips; and 15 control hips. In all regions, they found that the percentage of high-density area did not differ between the borderline-mild group and the control. In the anterolateral region, the authors observed a smaller percentage of high-density area in the borderline-mild group than in both the moderate group and the severe group. They write that the results suggest that unlike severe dysplasia, cumulative hip stress distribution in borderline-to-mild dysplasia was not concentrated on the lateral side of the acetabulum.

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The Leapfrog Group released its spring 2018 Leapfrog Hospital Safety Grades Of approximately 2,500 hospitals graded, 30 percent earned an A rating, 28 percent earned a B, 35 percent a C, 6 percent a D, and 1 percent an F. Among other things, the report notes that 46 hospitals achieved an A for the first time since the Leapfrog Hospital Safety Grade began six years ago, and 89 hospitals that received an A in the most recent report had at one point had received a D or F. Furthermore, the report finds that 45 hospitals (less than 2 percent overall) changed by two or more grades since fall 2014, with 33 displaying significant improvement and 12 showing significant decline.

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View the Hospital Safety Grade website…

A U.S. Food and Drug Administration (FDA) panel voted that the COX-2 inhibitor celecoxib poses no greater risk for heart attack and stroke than ibuprofen or naproxen. Celecoxib has been viewed as a safety risk since similar drugs rofecoxib and valdecoxib were removed from the market in 2004 and 2005 respectively. National Public Radio notes that, based on the committee’s conclusion, FDA may update advice regarding the safety of celecoxib. Although the agency is not required to follow the advice of advisory panels, it usually does.

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A report from the U.S. Government Accountability Office (GAO) finds that after eight years of testing, the U.S. Center for Medicare and Medicaid Innovation (CMMI) has recommended further development of only two of 37 payment models, with testing completed on 10. The two models recommended for extension are the Pioneer Accountable Care Organization Model and a diabetes prevention program. However, the report notes that CMMI has used its evaluations of previous payment models to inform the development of additional models, to make changes to models as they are implemented, and to recommend models for expansion.

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Read the GAO statement…

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Last call: Research Development Committee

May 4 is the last day to submit applications for a position on the Research Development Committee (one member-at-large opening). This committee oversees annual research symposia, the Kappa Delta orthopaedic research awards, the Clinician Scholar Career Development Program, and the Unified Orthopaedic Research Agenda, and is the Academy’s liaison group to the National Institutes of Health. Applicants for this position must be active fellows or associate members basic science.

Learn more and submit your application…  (member login required)