Postoperative opioid prescription and patient-reported outcomes after elective spine surgery: a Michigan Spine Surgery Improvement Collaborative study

Authors

Seokchun Lim, Henry Ford HealthFollow
Hsueh-Han Yeh, Henry Ford HealthFollow
Mohamed Macki, Henry Ford HealthFollow
Sameah A. Haider, Henry Ford HealthFollow
Travis Hamilton, Henry Ford HealthFollow
Tarek R. Mansour, Henry Ford HealthFollow
Edvin Telemi, Henry Ford HealthFollow
Lonni Schultz, Henry Ford HealthFollow
David R. Nerenz, Henry Ford HealthFollow
Jason M. Schwalb, Henry Ford HealthFollow
Muwaffak M. Abdulhak, Henry Ford HealthFollow
Paul Park
Ilyas Aleem
Richard Easton
Jad G Khalil
Miguelangelo Perez-Cruet
Victor Chang, Henry Ford HealthFollow

Recommended Citation

Lim S, Yeh HH, Macki M, Haider S, Hamilton T, Mansour TR, Telemi E, Schultz L, Nerenz DR, Schwalb JM, Abdulhak M, Park P, Aleem I, Easton R, Khalil JG, Perez-Cruet M, and Chang V. Postoperative opioid prescription and patient-reported outcomes after elective spine surgery: a Michigan Spine Surgery Improvement Collaborative study. J Neurosurg Spine 2022; 1-7.

Document Type

Article

Publication Date

10-7-2022

Publication Title

Journal of neurosurgery. Spine

Abstract

OBJECTIVE: This study was designed to assess how postoperative opioid prescription dosage could affect patient-reported outcomes after elective spine surgery.

METHODS: Patients enrolled in the Michigan Spine Surgery Improvement Collaborative (MSSIC) from January 2020 to September 2021 were included in this study. Opioid prescriptions at discharge were converted to total morphine milligram equivalents (MME). A reference value of 225 MME per week was used as a cutoff. Patients were divided into two cohorts based on prescribed total MME: ≤ 225 MME and > 225 MME. Primary outcomes included patient satisfaction, return to work status after surgery, and whether improvement of the minimal clinically important difference (MCID) of the Patient-Reported Outcomes Measurement Information System 4-question short form for physical function (PROMIS PF) and EQ-5D was met. Generalized estimated equations were used for multivariate analysis.

RESULTS: Regression analysis revealed that patients who had postoperative opioids prescribed with > 225 MME were less likely to be satisfied with surgery (adjusted OR [aOR] 0.81) and achieve PROMIS PF MCID (aOR 0.88). They were also more likely to be opioid dependent at 90 days after elective spine surgery (aOR 1.56).

CONCLUSIONS: The opioid epidemic is a serious threat to national public health, and spine surgeons must practice conscientious postoperative opioid prescribing to achieve adequate pain control. The authors' analysis illustrates that a postoperative opioid prescription of 225 MME or less is associated with improved patient satisfaction, greater improvement in physical function, and decreased opioid dependence compared with those who had > 225 MME prescribed.

PubMed ID

36208431

ePublication

ePub ahead of print

First Page

1

Last Page

7