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105. Factors Associated With Acute Pain Estimation, Postoperative Pain Resolution, Opioid Cessation, and Recovery

Author

Hah, Jennifer M., primary, Cramer, Eric, additional, Hilmoe, Heather, additional, Schmidt, Peter, additional, McCue, Rebecca, additional, Trafton, Jodie, additional, Clay, Debra, additional, Sharifzadeh, Yasamin, additional, Ruchelli, Gabriela, additional, Goodman, Stuart, additional, Huddleston, James, additional, Maloney, William J., additional, Dirbas, Frederick M., additional, Shrager, Joseph, additional, Costouros, John G., additional, Curtin, Catherine, additional, Mackey, Sean C., additional, and Carroll, Ian, additional

Published
2019
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108. DATAWATCH Opioid Abuse And Poisoning: Trends In Inpatient And Emergency Department Discharges

Author

Tedesco, Dario, Asch, Steven M., Curtin, Catherine, Hah, Jennifer, McDonald, Kathryn M., Fantini, Maria P., and Hernandez-Boussard, Tina

Subjects
Adult, Analgesics, Opioid, Male, Inpatients, Humans, Female, Middle Aged, Emergency Service, Hospital, Opioid-Related Disorders, Article, Patient Discharge
Abstract

Addressing the opioid epidemic is a national priority. We analyzed national trends in inpatient and emergency department (ED) discharges for opioid abuse, dependence, and poisoning using Healthcare Cost and Utilization Project data. Inpatient and ED discharge rates increased overall across the study period, but a decline was observed for prescription opioid-related discharges beginning in 2010, while a sharp increase in heroin-related discharges began in 2008.

Published
2017

109. Disparities in Access to Care Following Traumatic Digit Amputation.

Author

Long, Chao, Suarez, Paola A., Hernandez-Boussard, Tina, and Curtin, Catherine

Abstract

Background: Care of digit amputations ranges from revision amputation to replantation. Many factors determine the treatment type. We looked at the epidemiology of amputation and factors associated with escalation of care after presenting to the emergency department (ED). We hypothesized that disparities in care following digit amputation exist. Methods: We queried the State ED Databases and State Inpatient Databases of the Healthcare Cost and Utilization Project and developed a cohort using the diagnosis codes for thumb and finger amputation. Escalation of care was defined as patients whose disposition from the ED was referral to a higher level hospital or inpatient admission. Bivariate and multivariable analyses were conducted to identify the characteristics associated with escalation of care. Results: Our cohort included 45 586 patients, of which 37 539 (82.4%) were men; 7130 (15.6%) and 38 456 (84.4%) suffered a thumb or finger amputation, respectively. The mean age was 39.3 ± 20.4 years, and 7487 (16.4%) received escalated care. Female sex (odds ratio [OR] = 0.7) was a negative independent predictor of escalation of care, while high income (OR = 1.1), machinery-related mechanism (OR = 1.8), self-harm (OR = 4.2), thumb amputation (OR = 1.7), Medicaid (OR = 1.3) or Medicare (OR = 1.1) insurance, trauma hospitals (OR = 1.3), and metropolitan teaching hospitals (OR = 1.2) were positive predictors. Conclusions: Male patients who suffered a thumb and/or self-inflicted amputation, are from a higher income zip code, have Medicaid or Medicare insurance, and present to a teaching trauma center are more likely to receive escalated care. This highlights differences in care that can serve as a starting point for work on barriers to access. [ABSTRACT FROM AUTHOR]

Published
2020
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110. Trajectory analysis for postoperative pain using electronic health records: A nonparametric method with robust linear regression and K-medians cluster analysis.

Author

Weng, Yingjie, Tian, Lu, Tedesco, Dario, Desai, Karishma, Asch, Steven M, Carroll, Ian, Curtin, Catherine, McDonald, Kathryn M, and Hernandez-Boussard, Tina

Subjects
AGE distribution, CLINICAL medicine research, CLUSTER analysis (Statistics), ETHNIC groups, EXPERIENCE, LENGTH of stay in hospitals, PATIENT aftercare, MEDICAL appointments, MEDICAL care, NONPARAMETRIC statistics, NOSOLOGY, PATIENTS, POSTOPERATIVE pain, REGRESSION analysis, RESEARCH funding, SEX distribution, TIME, TOTAL knee replacement, SOCIOECONOMIC factors, PAIN measurement, DISCHARGE planning, TREATMENT duration, ELECTRONIC health records, PATIENTS' attitudes, STATISTICAL models, DESCRIPTIVE statistics, ODDS ratio
Abstract

Postoperative pain scores are widely monitored and collected in the electronic health record, yet current methods fail to fully leverage the data with fast implementation. A robust linear regression was fitted to describe the association between the log-scaled pain score and time from discharge after total knee replacement. The estimated trajectories were used for a subsequent K-medians cluster analysis to categorize the longitudinal pain score patterns into distinct clusters. For each cluster, a mixture regression model estimated the association between pain score and time to discharge adjusting for confounding. The fitted regression model generated the pain trajectory pattern for given cluster. Finally, regression analyses examined the association between pain trajectories and patient outcomes. A total of 3442 surgeries were identified with a median of 22 pain scores at an academic hospital during 2009–2016. Four pain trajectory patterns were identified and one was associated with higher rates of outcomes. In conclusion, we described a novel approach with fast implementation to model patients' pain experience using electronic health records. In the era of big data science, clinical research should be learning from all available data regarding a patient's episode of care instead of focusing on the "average" patient outcomes. [ABSTRACT FROM AUTHOR]

Published
2020
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111. Integrating Adjuvant Analgesics into Perioperative Pain Practice: Results from an Academic Medical Center.

Author

Chin, Kuo-Kai, Carroll, Ian, Desai, Karishma, Asch, Steven, Seto, Tina, McDonald, Kathryn M, Curtin, Catherine, and Hernandez-Boussard, Tina

Subjects
ACADEMIC medical centers, CONFIDENCE intervals, SCIENTIFIC observation, POSTOPERATIVE pain, TOTAL knee replacement, PAIN management, RETROSPECTIVE studies, PATIENT readmissions, ELECTRONIC health records, GABAPENTIN, DESCRIPTIVE statistics, NONOPIOID analgesics, PERIOPERATIVE care, TERTIARY care, PHARMACODYNAMICS
Abstract

Background Opioid-sparing postoperative pain management therapies are important considering the opioid epidemic. Total knee arthroplasty (TKA) is a common and painful procedure accounting for a large number of opioid prescriptions. Adjuvant analgesics, nonopioid drugs with primary indications other than pain, have shown beneficial pain management and opioid-sparing effects following TKA in clinical trials. We evaluated the adjuvant analgesic gabapentin for its usage patterns and its effects on opioid use, pain, and readmissions. Methods This retrospective, observational study included 4,046 patients who received primary TKA between 2009 and 2017 using electronic health records from an academic tertiary care medical institute. Descriptive statistics and multivariate modeling were used to estimate associations between inpatient gabapentin use and adverse pain outcomes as well as inpatient oral morphine equivalents per day (OME). Results Overall, there was an 8.72% annual increase in gabapentin use (P  < 0.001). Modeled estimates suggest that gabapentin is associated with a significant decrease in opioid consumption (estimate = 0.63, 95% confidence interval = 0.49–0.82, P  < 0.001) when controlling for patient characteristics. Patients receiving gabapentin had similar discharge pain scores, follow-up pain scores, and 30-day unplanned readmission rates compared with patients receiving no adjuvant analgesics (P  > 0.05). Conclusions When assessed in a real-world setting over a large cohort of TKA patients, gabapentin is an effective pain management therapy that is associated with reduced opioid consumption—a national priority in this time of opioid crisis—while maintaining the same quality of pain management. [ABSTRACT FROM AUTHOR]

Published
2020
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112. Feminist Therapy: A Comparative Study of Therapists and Clients.

Author

Curtin, Catherine A.

Abstract

Little research in the existing literature attempts to define feminist therapy by incorporating the specific experiences and philosophies of those who describe themselves as feminist therapists. Even less information is available about the perceptions of their clients. Therapists and their clients answered questions about the theoretical foundations of feminist therapy. The findings indicated that although therapists and clients responded in similar proportions to many items, discrepancies existed between responses about encouraging clients to "shop around" for a therapist and negotiating therapy contracts. The results suggest a need for further study of how closely the philosophies and practices of feminist therapists follow the theoretical definitions of this form of therapy. (JAC)

Published
1981

113. Electromyographic Analysis of Grip.

Author

Harwin, Steven F., Fox, Paige M., Oliver, Jeremie D., Nguyen, Viet, Hentz, Vincent R., and Curtin, Catherine M.

Abstract

This prospective cohort study used video electromyography synchronized analysis to determine the dynamic use of extrinsic and intrinsic finger flexion during grasp. Light fist formation primarily involved the flexor digitorum profundus with either the flexor digitorum superficialis or intrinsics. In contrast, both the flexor digitorum superficialis and intrinsics were recruited in all tight fist video electromyography. However, the sequence of recruitment differed between patients in tight fist formation. Injured patients demonstrated a unique pattern of recruitment based on injury. The authors conclude that the flexor digitorum profundus is the workhorse in composite fist formation but the roles of the flexor digitorum superficialis and the intrinsic muscles are less consistent across patients. [Orthopedics. 2019; 42(6):e555-e558.]. [ABSTRACT FROM AUTHOR]

Published
2019
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118. Effect of Perioperative Gabapentin on Postoperative Pain Resolution and Opioid Cessation in a Mixed Surgical Cohort

Author

Hah, Jennifer, primary, Mackey, Sean C., additional, Schmidt, Peter, additional, McCue, Rebecca, additional, Humphreys, Keith, additional, Trafton, Jodie, additional, Efron, Bradley, additional, Clay, Debra, additional, Sharifzadeh, Yasamin, additional, Ruchelli, Gabriela, additional, Goodman, Stuart, additional, Huddleston, James, additional, Maloney, William J., additional, Dirbas, Frederick M., additional, Shrager, Joseph, additional, Costouros, John G., additional, Curtin, Catherine, additional, and Carroll, Ian, additional

Published
2018
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121. Electronic Health Records and Quality of Care

Author

Yanamadala, Swati, Morrison, Doug, Curtin, Catherine, McDonald, Kathryn, and Hernandez-Boussard, Tina

Subjects
Adult, Male, Analysis of Variance, Adolescent, health care facilities, manpower, and services, Observational Study, social sciences, Middle Aged, Patient Readmission, United States, Patient Outcome Assessment, Young Adult, health services administration, Electronic Health Records, Humans, Regression Analysis, Female, Hospital Mortality, health care economics and organizations, Research Article, Aged, Quality of Health Care
Abstract

Electronic health records (EHRs) were implemented to improve quality of care and patient outcomes. This study assessed the relationship between EHR-adoption and patient outcomes. We performed an observational study using State Inpatient Databases linked to American Hospital Association survey, 2011. Surgical and medical patients from 6 large, diverse states were included. We performed univariate analyses and developed hierarchical regression models relating level of EHR utilization and mortality, readmission rates, and complications. We evaluated the effect of EHR adoption on outcomes in a difference-in-differences analysis, 2008 to 2011. Medical and surgical patients sought care at hospitals reporting no EHR (3.5%), partial EHR (55.2%), and full EHR systems (41.3%). In univariate analyses, patients at hospitals with full EHR had the lowest rates of inpatient mortality, readmissions, and Patient Safety Indicators followed by patients at hospitals with partial EHR and then patients at hospitals with no EHR (P 0.05). These results indicate that patients receiving medical and surgical care at hospitals with no EHR system have similar outcomes compared to patients seeking care at hospitals with a full EHR system, after controlling for important confounders. To date, we have not yet seen the promised benefits of EHR systems on patient outcomes in the inpatient setting. EHRs may play a smaller role than expected in patient outcomes and overall quality of care.

Published
2016

135. List of Contributors

Author

Abou-Sayed, Hatem, Afrooz, Paul N., Albornoz, Claudia R., Al Deek, Nidal F., Alderman, Amy K., Argenta, Louis C., Ariyan, Stephan, Avraham, Tomer, Berger, Aaron, Boyd, Kirsty Usher, Butler, Charles E., Butler, Peter E.M., Cao, Yilin, Cladis, Franklyn P., Constantian, Mark B., Cuzzone, Daniel A., Dhami, Gurleen, Gordillo, Gayle, Gurtner, Geoffrey C., Haeck, Phillip C., Halperin, Bruce, Heath, Daniel E., Hong, Joon Pio, Hu, Michael S., Hultman, C. Scott, Ibrahim, Amir E., Jazayeri, Leila, Jeffers, Brian, Jeffers, Lynn, Al Kahtani, Mohammed M., Kane, Gabrielle M., Kataru, Raghu P., Kerrigan, Carolyn L., King, Timothy W., Kinney, Brian M., Lee, W.P. Andrew, Lin Tay, Sherilyn Keng, Liu, Daniel Z., Liu, Wei, Longaker, Michael T., Lorenz, H. Peter, Mackinnon, Susan E., Marks, Malcolm W., Marre, Diego, Mathes, David W., Matros, Evan, Mazzola, Isabella C., Mazzola, Riccardo F., McHutchion, Lindsay D., Mehrara, Babak J., Morris, Steven F., Morrison, Wayne A., Neligan, Peter C., O'Connor, Andrea J., Ogawa, Rei, Orgill, Dennis P., Pang, Cho Y., Pestana, Ivo Alexander, Pietramaggior, Giorgio, Pusic, Andrea L., Reid, Russell R., Reisman, Neal R., Rosen, Joseph M., Roy, Sashwati, Rubin, J. Peter, Sarhane, Karim A., Sarwer, David B., Scherer-Pietramaggiori, Saja S., Seitz, Iris A., Selber, Jesse C., Sen, Chandan K., Sivak, Wesley N., Sudekum, M. Lucy, Taylor, G. Ian, Teven, Chad M., Tevlin, Ruth, Collins Vidal, E. Dale, Wan, Derrick C., Weber, Renata V., Wei, Fu-Chan, Wilkes, Gordon H., Wolfaardt, Johan F., Yap, Kiryu K., Yee, Andrew, Zielins, Elizabeth R., Ahmad, Jamil, Airan, Lisa E., Alter, Gary J., Aly, Al S., Al-Zahrani, Khalid, Armijo, Bryan, Baker, Daniel C., Barton, Fritz E., Jr., Baumann, Leslie, Berry, Miles G., Born, Trevor M., Bruner, Terrence W., Cánchica, Andrés F., Capella, Joseph F., Centeno, Robert F., Chiu, Ernest S., Choi, Jong Woo, Cohen, Steven R., Coleman, Sydney R., Couto, Rafael A., Cram, Albert, Dauwe, Phillip, Davies, Dai M., De la Peña Salcedo, Jose Abel, DiBernardo, Barry, Eaves, Felmont F., III, Ellis, Marco, Elyassnia, Dino, Few, Julius, Jr., Filho, Osvaldo Ribeiro Saldanha, Fisher, Jack, Flugstad, Nicholas A., Frame, James D., Gonzalez, Jazmina M., Greco, Richard J., Gruber, Ronald P., Guyuron, Bahman, Hunstad, Joseph P., Ishii, Clyde H., Jarrett, Nicole J., Jelks, Elizabeth B., Jelks, Glenn W., Jewell, Mark Laurence, Kahn, David M., Kane, Michael A.C., Kaufman, David L., Kenkel, Jeffrey, Koh, Kyung S., Leong, Tracy, Levine, Steven M., Locke, Michelle B., Lolofie, Alyssa, Marten, Timothy J., Mendelson, Bryan, Mendieta, Constantino G., Metcalfe, Drew B., Miotto, Gabriele C., Nahai, Foad, Obagi, Suzan, de Paiva, Sabina Aparecida Alvarez, Perdikis, Galen, Posner, Jason, Richter, Dirk F., Roberts, Thomas L., III, Ledezma Rodriguez, Jocelyn Celeste, Rohrich, Rod J., Ross, E. Victor, Saad, Ahmad N., Saboeiro, Alesia P., Saldanha, Cristianna Bonnetto, Saldanha, Osvaldo, Saltz, Renato, Sanjuan, Paulo Rodamilans, Schwaiger, Nina, Steinbrech, Douglas S., Stephan, Phillip J., Sosa, David Gonzalez, Stuzin, James M., Suissa, Daniel, Thorne, Charles H., Totonchi, Ali, Toy, Jonathan W., Trovato, Matthew J., Wall, Simeon H., Jr., Waltzman, Joshua T., Warren, Richard J., Weisberg, Edmund, Woehrle, Scott, Wong, Chin-Ho, Yan, Alan, Yaremchuk, Michael J., Zins, James E., Adler, Neta, Afifi, Ahmed M., Alvarado, Marta, Arnaud, Eric, Baker, Stephen B., Bartlett, Scott P., Bauer, Bruce S., Baylis, Adriane L., Bentz, Mike, Birgfeld, Craig, Boysen, William R., Bradley, James P., Buchanan, Edward P., Bykowski, Michael R., Caterson, Edward J., Chan, Rodney K., Chang, Edward I., Chen, Constance M., Chen, Yu-Ray, Chen, Philip Kuo-Ting, Cheng, Ming-Huei, Chinchilla, Gerson R., Cordeiro, Peter G., Córdova-Aguilar, Alberto, Davidson, Edward H., Dickie, Sara R., Djohan, Risal S., Dorafshar, Amir H., Fearon, Jeffrey A., Figueroa, Alexander L., Figueroa, Alvaro A., Fisher, David M., Flores, Roberto L., Foreman, Andrew, Gerety, Patrick A., Goldstein, Jesse A., Gosain, Arun K., Gottlieb, Lawrence J., Greene, Arin K., Gullane, Patrick J., Gundeti, Mohan S., Gur, Eyal, Hanasono, Matthew M., Harada, Toshinobu, Helms, Jill A., Hirsch, David L., Huang, Jung-Ju, Hoffman, William Y., Hollier, Larry H., Jr., Hopper, Richard A., Hussain, Gazi, Jackson, Oksana, James, Syril, Kapur, Sahil, Kawamoto, Henry K., Jr., Khechoyan, David Y., Kirschner, Richard E., Koshy, John C., Large, Michael C., Lee, Edward I., Levine, Jamie P., Li, Jingtao, Lin, Lawrence, Losee, Joseph E., Low, David W., Manktelow, Ralph T., Manson, Paul N., Menick, Frederick J., Molina, Fernando, Monson, Laura A., Mueller, Reid V., Mulliken, John B., Mundinger, Gerhard S., Murphy, Blake D., Noordhoff, M. Samuel, Paternoster, Giovanna, Pomerantz, Jason, Pribaz, Julian J., Purnell, Chad A., Rodriguez, Eduardo D., Rowin, Craig, Sanchez, Ruston J., Schuster, Lindsay A., Un Chang See, Jeremiah, Shetye, Pradip R., Skoracki, Roman, Slidell, Mark B., Sosin, Michael, Tahiri, Youssef, Taub, Peter J., Taylor, Jesse A., Torok, Kathryn S., Wilson, Kris, Wolfe, S. Anthony, Yamada, Akira, Yu, Peirong, Zuker, Ronald M., Attinger, Christopher E., Borghese, Lorenzo, Chang, David W., Claes, Karel, Clemens, Mark W., II, Colohan, Shannon M., D'Arpa, Salvatore, DeFazio, Michael V., Dellon, A. Lee, Ducic, Ivica, Dumanian, Gregory A., Felder, John M., III, Giessler, Goetz A., Han, Kevin D., Hoebeke, Piet, Howard, Michael A., Janis, Jeffrey E., Kleiber, Grant M., Kovach, Stephen J., III, Kwon, Robert, Lee, Raphael C., Levin, L. Scott, Louie, Otway, Lumen, Nicolas, Masellis, Alessandro, Masellis, Michele, Milner, Stephen M., Momeni, Arash, Monstrey, Stan, N, Venkateshwaran, Parikh, Rajiv P., Sarto Piccolo, Mônica, Sarto Piccolo, Nelson, Sarto Piccolo, Maria Thereza, Puri, Vinita, Rawlani, Vinay, Rendon, Juan L., Roughton, Michelle C., Said, Hakim K., Saint-Cyr, Michel, Sauerbier, Michael, Schechter, Loren S., Song, David H., Sur, Yoo Joon, Allen, Robert J., Sr., Austin, Ryan E., Beber, Brett, Blondeel, Philip N., Brown, Benjamin J., Brown, Mitchell H., Calobrace, M. Bradley, Carlson, Grant W., Chang, Bernard W., Cohen, Robert, Colwell, Amy S., Delay, Emmanuel, Egro, Francesco M., Fine, Neil A., Flores, Jaime, Fosnot, Joshua, Gabriel, Allen, Gart, Michael S., Goodwin, Matthew D., Guerid, Samia, Hamdi, Moustapha, Hart, Alexandra M., Hartmann, Emily C., Khavanin, Nima, Kim, John Y.S., Kronowitz, Steven, Larson, John V., Lee, Z-Hye, Lista, Frank, Losken, Albert, Malata, Charles M., Masià, Jaume, Maxwell, G. Patrick, Mayo, James L., Miranda, Roberto N., Morrison, Colin M., Nahabedian, Maurice Y., Namnoum, James D., Nelson, Maria E., Park, Julie, Patel, Ketan M., Patel, Nakul Gamanlal, Pons, Gemma, Ramakrishnan, Venkat V., Rodríguez-Bauzà, Elena, Schwartz, Michael R., Sener, Stephen F., Serletti, Joseph M., Shenaq, Deana S., Shestak, Kenneth C., Somogyi, Ron B., Spear, Scott L., Spring, Michelle A., Stevens, W. Grant, Craig, Elizabeth Stirling, Talbot, Simon G., Van Thielen, Jana, Wilson, Henry, Wong, Kai Yuen, Ahn, Hee Chang, Azari, Kodi K., Baldrighi, Carla, Borschel, Gregory H., Brandacher, Gerald, Butler, Lesley, Calfee, Ryan P., Carlsen, Brian T., Chang, James, Chase, Robert A., Chong, Alphonsus K.S., Chuang, David Chwei-Chin, Chung, Kevin C., Cox, Christopher, Curtin, Catherine, Dahlin, Lars B., Donohue, Kenneth W., Dzwierzynski, William W., Farnebo, Simon, Fox, Ida K., Fox, Paige M., Friedrich, Jeffrey B., Haase, Steven C., Hagert, Elisabet, Hammert, Warren C., Harvey, Isaac, Hentz, Vincent R., Hill, Jonay, Hovius, Steven E.R., Huang, Jerry I., Innocenti, Marco, Jones, Neil F., Kakinoki, Ryosuke, Kang, Jason R., Khouri, Joseph S., Kuiken, Todd, Lalonde, Donald, Legrand, Anais, Light, Terry, Lim, Jin Xi, Lopez, Joseph, Mailey, Brian, McCabe, Steven J., Megerle, Kai, Moore, Amy M., Moran, Steven L., Neiduski, Rebecca L., Netscher, David T., Neumeister, Michael W., Noland, Shelley, Novak, Christine B., Oates, Scott, Oberg, Kerby, Oishi, Scott, Pederson, William C., Pham, Dang T., Prommersberger, Karl-Josef, Reinholdt, Carina, Sacks, Justin M., Sammer, Douglas M., Sen, Subhro K., Sharma, Pundrique R., Sherman, Randolph, Shores, Jaimie T., Singh, Vanila M., Souza, Jason M., Taghinia, Amir, Tan, David M.K., Tang, Jin Bo, Thorfinn, Johan, Tonkin, Michael, Upton, Joseph, III, Valero-Cuevas, Francisco, van Nieuwenhoven, Christianne A., Vedder, Nicholas B., Watt, Andrew J., Woodside, Julie Colantoni, and Yao, Jeffrey

Published
2018
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143. A Double-Blind Placebo Randomized Controlled Trial of Minocycline to Reduce Pain After Carpal Tunnel and Trigger Finger Release.

Author

Curtin, Catherine M., Kenney, Debbie, Suarez, Paola, Hentz, Vincent R., Hernandez-Boussard, Tina, Mackey, Sean, and Carroll, Ian R.

Abstract

Purpose Minocycline is a microglial cell inhibitor and decreases pain behaviors in animal models. Minocycline might represent an intervention for reducing postoperative pain. This trial tested whether perioperative administration of minocycline reduced time to pain resolution (TPR) after standardized hand surgeries with known prolonged pain profiles: carpal tunnel release (CTR) and trigger finger release (TFR). Methods This double-blinded randomized controlled trial included patients undergoing CTR or TFR under local anesthesia. Before surgery, participants recorded psychological and pain measures. Participants received oral minocycline, 200 mg, or placebo 2 hours prior to procedure, and then 100 mg of minocycline or placebo 2 times a day for 5 days. After surgery, participants were called daily assessing their pain. The primary end point of TPR was when participants had 3 consecutive days of 0 postsurgical pain. Futility analysis and Kaplan-Meier analyses were performed. Results A total of 131 participants were randomized and 56 placebo and 58 controls were analyzed. Median TPR for CTR was 3 weeks, with 15% having pain more than 6 weeks. Median TPR for TFR was 2 weeks with 18% having pain more than 6 weeks. The overall median TPR for the placebo group was 2 weeks (10% pain > 6 weeks) versus 2.5 weeks (17% pain > 6 weeks) for the minocycline group. Futility analysis found that the likelihood of a true underlying clinically meaningful reduction in TPR owing to minocycline was only 3.5%. Survival analysis found minocycline did not reduce TPR. However, subgroup analysis of those with elevated posttraumatic distress scores found the minocycline group had longer TPR. Conclusions Oral administration of minocycline did not reduce TPR after minor hand surgery. There was evidence that minocycline might increase length of pain in those with increased posttraumatic stress disorder symptoms. Type of study/level of evidence Therapeutic I. [ABSTRACT FROM AUTHOR]

Published
2017
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150. Soft-Tissue Coverage of the Hand

Author

Eberlin, Kyle R., primary, Chang, James, additional, Curtin, Catherine M., additional, Sammer, Douglas M., additional, Saint-Cyr, Michel, additional, and Taghinia, Amir H., additional

Published
2014
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