Louisiana Via Research Day Book 2026

Clinical Research

Clinical Research

113 BODY MASS INDEX AND OPIOD PRESCRIBING AFTER INRAUTERINE DEVICE INSERTION: EXPLORING THE VARIABILITY BETWEEN PERCEIVED PAIN AND PAIN MANAGEMENT PRACTICES

114 COMPARATIVE EFFECTIVENESS OF MULTIMODAL SURGICAL SITE INFECTION PREVENTION STRATEGIES IN ORTHOPEDIC SURGERY

Sarah Silva OMS-II; Sara Toal OM-II; Hanh Tran, OMS-II; Savannah Newell, PhD VCOM-Louisiana

Stephen Johns, OMS-II; Ryan Jordan, OMS-II; Erica Jeffress, OMS-II; Randolph Devereaux, PhD VCOM-Louisiana

Context: Intrauterine device (IUD) insertion is commonly characterized as a painful procedure, yet pain management practices remain highly variable and lack standardization. Despite this perception, opioid prescribing following IUD insertion appears uncommon. Body mass index (BMI) is frequently considered during procedural planning and analgesic decision-making, but its role in post-insertion opioid prescribing remains unclear. Understanding these patterns may clarify whether prescribing practices align with patient-reported pain and evidence-based recommendations. Objective: To determine the association between BMI and opioid prescribing following intrauterine device insertion. Methods: A retrospective cohort analysis was conducted using data from the NIH All of Us Research Program. The study sample included 12,586 IUD insertion procedures performed in 6,259 individual patients between 2005 and 2023. Only procedures involving IUD insertion were analyzed. Opioid prescriptions issued within 14 days of insertion were identified. Multivariable logistic regression models

assessed the association between BMI and opioid prescribing while adjusting for age at procedure, race, median household income, year of insertion, prior IUD placement, and misoprostol use. Results: More than 80% of IUD insertions were not associated with an opioid prescription, with only approximately 4% resulting in opioid prescription. BMI demonstrated a statistically significant association with opioid prescribing (p < 0.001), though the effect size was small (OR = 1.02 per unit increase in BMI). Patients who did not receive opioid prescriptions had a lower average BMI compared to those who did. Opioid prescribing increased modestly over time (OR = 1.05 per year). Race and socioeconomic status were correlated with BMI and were included as covariates in all models. Conclusion: Opioid prescribing following IUD insertion is uncommon despite the procedure frequently being described as painful. Although BMI was statistically associated with opioid use, the small effect size suggests that BMI alone may not be a clinically meaningful driver of post-insertion opioid prescribing. These

findings highlight variability in pain management practices following IUD insertion and underscore the need for further investigation into factors influencing analgesic decision-making.

Context: Surgical site infections (SSIs) remain a significant source of morbidity in orthopedic surgery, leading to prolonged hospitalization, increased healthcare costs, and higher revision rates. Despite established guidelines, variability in perioperative practices persists, and the relative effectiveness of isolated versus bundled SSI prevention strategies remains unclear. Objective: We hypothesized that a bundled, multimodal SSI prevention strategy would result in greater reductions in postoperative infection rates compared with single-intervention approaches. Methods: We conducted a retrospective before and-after cohort study utilizing de-identified data from a tertiary academic orthopedic center. Adult patients undergoing elective and trauma related orthopedic procedures were included. Interventions evaluated included standardized perioperative antibiotic timing and selection, preoperative chlorhexidine bathing and nasal decolonization, and intraoperative workflow modifications. SSI rates were compared across baseline, single-intervention, and bundled intervention phases using CDC criteria.

Comparative analyses were performed using chi-square testing.

Results/Anticipated Results: A total of 1,248 procedures were analyzed. Baseline SSI rates were 2.8%. Single-intervention strategies produced modest reductions in SSI rates to 2.1%, while bundled prevention strategies resulted in the greatest reduction to 0.9% (p<0.05). Reductions were most pronounced in deep and gram-negative infections. No increase in antibiotic-related adverse events was observed. Conclusion: Multimodal SSI prevention strategies were more effective than isolated interventions in reducing postoperative infections in orthopedic surgery. These findings support the implementation of bundled, standardized prevention protocols to improve surgical outcomes.

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2026 Research Recognition Day