{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:53:24Z","timestamp":1791294804361,"version":"4.1.0"},"reference-count":44,"publisher":"Walter de Gruyter GmbH","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_sjpain-2026-0028_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Persistent pain after major lower extremity amputation (MLEA) is common. This study aimed to investigate opioid and non-opioid analgesic consumption, defined by drug group, one year before and after MLEA and to investigate risk factors for postoperative opioid\u00a0use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2026-0028_abs_002\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Through the Danish National Patient Registry, we identified 7,012 patients,\u00a0\u226550 years, alive one year postoperatively, with first-time MLEA performed in 2010\u20132021, divided in below-knee (BKA) and above-knee amputations (AKA). Prescription redemptions were used as a proxy for analgesic use, which was analysed by drug class: Opioids, and non-opioids: NSAIDs, paracetamol, anticonvulsants, antidepressants, and other. Long-term opioid users were defined as patients with\u00a0\u22651 redeemed opioid prescription in all four quarters post-amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2026-0028_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Opioid-use peaked in the quarter before MLEA (-Q1) at 93\u202f% (CI 92\u201393\u202f%) and remained higher one year after (37\u202f%, CI 36\u201338\u202f%) compared with one year before (25\u202f%, CI 24\u201326\u202f%). Long-term opioid use rose from 19\u202f% (CI 18\u201320\u202f%) to 28\u202f% (CI 27\u201329\u202f%). Paracetamol (93\u202f%, CI 92\u201393\u202f%), anticonvulsants (58\u202f%, CI 57\u201360\u202f%), and antidepressants (39\u202f%, CI 38\u201340\u202f%) peaked at\u00a0\u2013\u00a0Q1, declining but exceeding baseline at one year. Female sex (OR 1.3, CI 1.2\u20131.5), AKA level (OR 1.5, CI 1.5\u20131.7), and long-term \u201cother\u201d analgesic use (OR 2.2, CI 1.6\u20133.0) were risk factors for new long-term opioid\u00a0use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_sjpain-2026-0028_abs_004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, the use of opioids and non-opioid analgesics increased before MLEA, peaking before surgery. Postoperatively, the use declined but remained higher than in the pre-amputation\u00a0year.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/sjpain-2026-0028","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:56:48Z","timestamp":1791291408000},"source":"Crossref","is-referenced-by-count":0,"title":["Analgesic consumption after major lower extremity amputation\u00a0\u2013\u00a0a Danish nationwide register-based study from 2010\u20132021"],"prefix":"10.1515","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6732-853X","authenticated-orcid":false,"given":"Jeppe Marinus","family":"Mortensen","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology , Odense University Hospital , Odense , Denmark"},{"name":"Department of Clinical Research , University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Trier","family":"Heiberg Brix","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology , Odense University Hospital , Odense , Denmark"},{"name":"Department of Clinical Research , University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine Bollerup","family":"Arndt","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery , Kolding Hospital , Kolding , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tine","family":"Nymark","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology , Odense University Hospital , Odense , Denmark"},{"name":"Department of Clinical Research , University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lindberg-Larsen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Traumatology , Odense University Hospital , Odense , Denmark"},{"name":"Department of Clinical Research , University of Southern Denmark , Odense , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"2026100612564357551_j_sjpain-2026-0028_ref_001","doi-asserted-by":"crossref","unstructured":"Kalbaugh, CA, Strassle, PD, Paul, NJ, McGinigle, KL, Kibbe, MR, Marston, WA. 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