Erin A. Brennand

Introduction Our objective was to explore the relation between patient age and postoperative opioid use up to 24 hours following pelvic organ prolapse (POP) surgery. Material and methods We conducted a prospective cohort study following 335 women ranging in age from 26 to 82 years who underwent surgery for multi‐compartment POP at a tertiary center in Alberta, Canada. Patient characteristics were measured using baseline questionnaires. Perioperative data were collected from medical chart review during and up to 24 hours following surgery. We used logistic regression to analyze the odds of being opioid‐free and linear regression to analyze mean differences in opioid dose, measured as total morphine equivalent daily dose, exploring for a potential non‐linear effect of age. Adjusted models controlled for preoperative pain, surgical characteristics and patient health factors. Results Overall, age was positively associated with greater odds of being opioid‐free in the first 24 hours after surgery (adjusted odds ratio per increasing year of age = 1.07, 95% confidence interval [CI] 1.04–1.09, n = 332 women). Among opioid users, age was inversely associated with total opioid dose (adjusted mean difference per increasing year of age = 0.71 mg morphine equivalent daily dose, 95% CI −0.99 to −0.44, n = 204 women). There was no evidence of a non‐linear relation between age and postoperative opioid use or dose. Conclusions In the context of POP surgery, we found that younger women were more likely to use opioids after surgery and to use a higher dose in the first 24 hours when compared with older women. These findings support physicians to consider age when counseling POP patients regarding pain management after surgery, and to direct resources aimed at opioid‐free pain control towards younger patients.

It has been suggested that disabled people may experience higher rates of sexually transmitted infections (STI) due to health inequities and sexual education gaps. Using a pan-Canadian health survey, we sought to explore the association with disability and STI. Using the public use microdata file for the 2013–2014 cycles of the Canadian Community Health Survey (Statistics Canada), the association between disability and STI was explored. Modelling included adjustment for age, ethnicity, geography, living arrangement, educational status, and marital status. Results were stratified for females and males, disability severity, and type. Both females (odds ratio [OR] 1.54, 95% confidence intervals [CI] 1.27–1.86) and males (OR 1.29, 95% CI 1.03–1.62) with any impairments were more likely to report a diagnosis of STI. A graduated effect was seen, with the odds increasing as the severity of disability increased. Females with severe visual impairment (OR 6.88, 95% CI 2.13–22.17) had the highest association with STI. Associations were most consistently seen in females, suggesting sex differences in risk for disabled people. Given that Canadians living with disabilities are more likely to report having been diagnosed with a STI, future work is needed to further understand the causes. In the meantime, these findings signal a need for clinicians to ensure this group is engaged with STI screening, as well as the greater need for improved strategies to address the sexual health needs of those living with a disability of all severities and types.